Positive Beginnings Supporting young children with challenging behavior

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graphic Determining the Meaning of Challenging Behavior
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Learner Objectives
This workshop will teach you to:

  • define forms and function of communication and identify the behavioral mechanisms that contribute to viewing challenging behavior as communicative.
  • identify methods that may be used to determine the function of challenging behavior.
  • use interview and observation data to determine the communicative function of challenging behavior.
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Old Way – New Way

Old Way

  • General intervention for all behavior challenges
  • Intervention is reactive
  • Focus on behavior reduction
  • Quick fix

New Way

  • Intervention matched to purpose of the behavior
  • Intervention is proactive
  • Focus on teaching new skills
  • Long term interventions
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Positive Behavior Support (PBS)

  • An approach for changing a child’s behavior
  • Is based on humanistic values and research
  • An approach for developing an understanding of why the child has challenging behavior and teaching the child new skills to replace challenging behavior
  • A holistic approach that considers all of the factors that impact on a child, family, and the child’s behavior
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Research on PBS

  • Effective for all ages of individuals with disabilities 2-50 years
  • Effective for diverse groups of individuals with challenges: mental retardation, oppositional defiant disorder, autism, emotional behavioral disorders, children at risk, etc.
  • PBS is the only comprehensive and evidence-based approach to address challenging behavior within a variety of natural settings.
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Challenging Behavior Communicates

  • Communicates a message when a child does not have language
  • Used instead of language by a child who has limited social skills or has learned that challenging behavior will result in meeting his or her needs
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Challenging Behavior

  • Children engage in challenging behavior because “it works” for them
  • Challenging behavior results in the child gaining access to something or someone (i.e., obtain/request) or avoiding something or someone (i.e., escape/protest)
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Dimensions of Communication

Every communicative behavior can be described by the form and function

  • Function: the reason or purpose of the communicative behavior
  • Form: the behavior used to communicate
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Children Communicate a Variety of Messages

  • Functions of communication
    • Request object, activity, person
    • Escape demands
    • Escape activity
    • Request help
    • Request social interaction
    • Comment
    • Request information
    • Request sensory stimulation
    • Escape sensory stimulation
    • ?
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Children Communicate in Many Ways:

  • Forms of communication
    • Words
    • Sentences
    • Point to a picture
    • Eye gaze
    • Pulling Adult
    • Crying
    • Biting
    • Tantrums
    • ?
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Evan

  • Evan is playing with Duplos. He tries to attach a block to his stack of 3. He can’t quite get the blocks to connect. He looks up at the adult and begins fussing. He holds the stack of blocks up, looks at the blocks, and looks at the adult. The adult helps him put the blocks together.
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Shana

  • Shana is sitting in her high chair with nothing on the tray. Her mother is stirring her oatmeal. Shana begins crying and bangs her head on the back of the seat. Her mother says to her "It's not cool enough, honey, just a minute". Shana stops crying when the oatmeal is placed on her tray.
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Cameron

  • Cameron is riding a trike on the playground bike path. He sees a child move to the sand box where he had just finished building a road-way. He leaps off his trike and tackles the child. He hits the child. An adult comes over to intervene. She comforts the child and scolds Cameron. Cameron goes to the sand box and continues construction on his road-way.
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Michelle

  • Michelle is in housekeeping, putting on high heels and a hat. Emily moves into the area and selects a purse from the dress-ups. Michelle shouts “no” and bites Emily. A teacher comes over, she asks Michelle to go to the thinking chair and takes Emily to the bathroom to look at the bite. After 4 minutes, Michelle leaves the thinking chair and returns to housekeeping. She grabs the purse Emily had selected and continues to play. Emily leaves the bathroom with the teacher and then begins an art activity where the teacher is present.
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Behavior Equation

Trigger
Joey is asked to come to circle. Teacher provides physical prompt to move him to group

Behavior
Joey resists and cries, hits teacher

Maintaining Consequence
Teacher moves away from Joey and allows Joey to select a different activity

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Setting Event

Event that occurs at another time that increases the likelihood the child will have challenging behavior. Setting events serve to “set the child up” to have challenging behavior.

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Behavior Equation

Setting Event

Trigger
Quan approaches computer and sees child working on program

Behavior
Quan moves his picture to indicate that he is next. Quan observes and waits for his turn

Maintaining Consequence
Child leaves computer and Quan sits down and begins working

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Behavior Equation

Setting Event
Quan was up most the night with an asthma attack. He arrives at school looking sleepy and with dark circles under his eyes.

Trigger
Quan approaches computer and sees child working on program

Behavior
Quan hits child and pushes his body on the child’s chair

Maintaining Consequence
Child leaves computer and Quan sits down and begins working

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Process of Positive Behavior Support

Step 1: Establishing a collaborative team and identifying goals

Step 2: Gathering information (functional assessment)

Step 3: Developing hypotheses (best guess)

Step 4: Designing behavior support plans

Step 5: Implementing, monitoring, evaluating outcomes and refining plan in natural environments

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Functional Assessment

  • A process for developing an understanding of a person’s challenging behavior and, in particular, how the behavior is governed by environmental events.
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Functional Assessment

  • Observe the child in target routines and settings
  • Collect data on child behavior, looking for situations that predict challenging behavior and that are linked with appropriate behavior
  • Interview persons most familiar with the child
  • Review records
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0
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2 ABC
3 DEF
4 GHI
5 JKL
6 MNO
7 PQRS
8 TUV
9 WXYZ
* TONE
0 OPER
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Observation Card

Name:

Observer:

Date:

General Context:

Time:

Trigger:

Challenging Behavior:

Maintaining Consequence:

POSSIBLE FUNCTION:

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Observation Card

Name:
Karen

Observer:
Teacher

Date:
1/22

General Context:
Choice time/Art

Time:
10:00

Trigger:
Playing alone in house. Teacher comes over to Karen and asks her to come to the art table for art. When she doesn’t respond, the teacher tries to assist her by taking her arm to nudge her to stand.

Challenging Behavior:
Karen pulls away and begins to protest by saying, “No! I not go to art,” as she pulls away from the teacher.

Maintaining Consequence:
The teacher walks away and says, “I will be back in a few minutes to see if you are ready.

POSSIBLE FUNCTION:
Escape art.

graphic Observation Vignette #1
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Observation Card

Name:
Segment 1

Observer:

Date:

General Context:
Choice Time

Time:

Trigger:
Playing alone in block play. Goes over to a group of children playing.

Challenging Behavior:
Sticks out tongue and makes raspberry sound, hits boy, scratches his shoulder.

Maintaining Consequence:
Boy yells at him, friend brings him a lizard,
boy yells to teacher.

POSSIBLE FUNCTION:
Initiate social interaction/Join play

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Observation Card

Name:
Segement 2

Observer:

Date:

General Context:
Playtime

Time:

Trigger:
Playground play with 2 friends. Girl goes to basket and gets truck just like the other friend’s truck.

Challenging Behavior:
He tries to take her truck, shoves, pushes, and continues tugging for toy.

Maintaining Consequence:
Gets toy for a second, continues to fight girl for
toy , teacher reprimands and carries him away.

POSSIBLE FUNCTION:
Obtain the toy (same truck as “best friend’s”)

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Observation Card

Name:
Segment 3

Observer:

Date:

General Context:
Computer

Time:

Trigger:
Brother is having a turn at the computer. Brother sits. Mom says 1. Josh 2. Brendan. Brendan says, “It’s Brendan’s turn.”

Challenging Behavior:
B. yells, falls to ground, pulls chair, kicks, cries.

Maintaining Consequence:
Josh protests, mother says, “Do you want me to
carry you?” B. says,“Carry me.” She carries him away.

POSSIBLE FUNCTION:
Obtain computer/Adult attention

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Observation Card

Name:
Segment 4

Observer:

Date:

General Context:
Enter Library

Time:

Trigger:
Going into library. Mother says, “Let’s go inside.” Then she counts down.

Challenging Behavior:
Drops to floor, resists moving, screams, kicks, tries to run, drops, resists, screams, becomes “wet noodle.”

Maintaining Consequence:
Mother pulls him through doors then picks him
up as he resists.

POSSIBLE FUNCTION:
Escape/avoid going into the library (prolonged)
(and adult attention)

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Observation Card

Name:
Segment 5

Observer:

Date:

General Context:
Circle with Puppet

Time:

Trigger:
Teacher kisses children’s cheeks with puppet. Says, “Say good-bye to MiMi.” Teacher gets up to put away puppet.

Challenging Behavior:
Hitting self on head with fist, pull at shirt

Maintaining Consequence:
Adult says “Ready to dance? Want to dance Ryan?” Goes and sits in her lap and is smiling.

POSSIBLE FUNCTION:
Adult attention

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Observation Card

Name:
Segment 6

Observer:

Date:

General Context:
Center Time

Time:

Trigger:
Teacher helps child to sit then walks away to find him a toy while saying, “Let Ms. Genie get you some balls.”

Challenging Behavior:
Pulls arm out of shirt, hits self on head with fist, thrusts backwards, pulls at shirt, kicks.

Maintaining Consequence:
Teacher returns, talks to, helps him get shirt back
on, and hugs.

POSSIBLE FUNCTION:
Adult attention

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Observation Card

Name:
Segment 7

Observer:

Date:

General Context:
In Kitchen

Time:

Trigger:
Mother’s drink is on counter, mother and child are in kitchen

Challenging Behavior:
Child cries, points, whines, runs to counter, reaches, tries to climb counter to get drink, screams

Maintaining Consequence:
Told, “No, that’s Mama’s”; mom is told by consultant to do whatever she would typically do; Mother dumps cup to get child drink

POSSIBLE FUNCTION:
Get to drink out of Mama’s cup

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Observation Card

Name:
Segment 8

Observer:

Date:

General Context:
In Family Room Getting Dressed

Time:

Trigger:
Mother says, “Come here; let’s get dressed”

Challenging Behavior:
Child runs, cries, swings body backwards when
mother lifts her, screams, runs away again, hides

Maintaining Consequence:
Mother lets go of her and when she runs again
her mother says, “I’m gonna get you…I’m gonna get you….are you hiding?”

POSSIBLE FUNCTION:
Escape or prolong getting dressed/gets to play
“hide and seek”

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Home Observation Card

Child's Name:

Date:

Activity:

Observer:

Describe Challenging Behavior:

What Happened Before?

  • told or asked to do something
  • removed an object
  • not a preferred activity
  • difficult task/activity
  • playing alone
  • moved activity/location to another
  • told "No," "Don't," "Stop"
  • attention given to others
  • changed or ended activity
  • object out of reach
  • child requested
  • other:

What Happened After?

  • given social attention
  • given an object/activity/food
  • removed from activity or area
  • punished or scolded
  • request or demand withdrawn
  • request or demand delayed
  • put in "time out"
  • ignored
  • given assistance/help
  • other:

Purpose of Behavior?
To Get or Obtain:

  • activity
  • object
  • person
  • help
  • attention
  • food
  • place
  • other:

To Get Out of or Avoid:

  • activity
  • object
  • person
  • demand/request
  • attention
  • food
  • place
  • transition
  • other:
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Home Observation Card

Setting Events/Lifestyle Influences:

  • hunger
  • absence of fun activities
  • absence of a person
  • sick
  • unexpected loss or change in activity/object
  • uncomfortable clothing
  • to hot or cold
  • loud noise
  • lack of sleep
  • medication side effects
  • extreme change in routine
  • other:

List notes / Comments / Unusual Events:

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Activity Analysis

Child: Rachel
Routine/Activity:
House Center

Activity Description:
Steps:

  1. Select materials
  2. Pretend in roles
  3. Exchange materials with peers
  4. Follow peers’ lead or accept role assignment
  5. Clean-up

Behavior Expectations:

  1. Pick materials that no one is using
  2. Use materials appropriately
  3. Don’t take from peer
  4. Maintain engagement
  5. Put materials on shelf in correct area

Problems:

3. Takes materials from others
4. Ignores peers, interferes in play

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Activity Analysis

Child: Rachel
Routine/Activity:
Snack

Activity Description:
Steps:

  1. Sit in chair
  2. Take food from plate when passed
  3. Eat food on plate
  4. Drink juice from own cup
  5. Ask for more food
  6. Wipe face with napkin
  7. Throw plate/cup/napkin away when finished

Behavior Expectations:

  1. Stay in seat
  2. Take one item, wait for turn
  3. Eat from own plate
  4. Drink and put cup on table
  5. Ask using please
  6. Use napkin, not clothing
  7. Clear place, throw in trash

Problems:

2. Takes multiple items, puts hand in bowl, grabs while plate is passed
3. Takes food from other children’s plates
4. Grabs food when she wants more

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Functional Assessment Interview

  • Define behavior (describe what you see)
  • Describe frequency and intensity
  • Explore possible setting events
  • Identify predictors (triggers)
  • Identify maintaining consequences
  • Identify current communicative functions
  • Describe efficiency of the behavior
  • Describe previous efforts
  • Identify possible reinforcers
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Functional Assessment Interview

  • Refer to Brendan’s Sample Functional Assessment Interview
  • BrendansFAI.pdf
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Working as a Collaborative Team

  • Assign roles
  • Determine agenda and time for meetings
  • Ensure group participation through facilitation and participatory processes
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Roles

  • Facilitator – person who guides group in stating agenda, work goals, time allocation
  • Recorder – person who writes down the discussion
  • Time Keeper – Person who tracks time and warns when agenda item is ending
  • Reporter – person who shares group information, makes presentation
  • Encourager – person who provides feedback to group members
  • Jargon-buster – person who asks the question “what do you mean when you say ‘gobbley-gook’ and helps the group with communicating clearly
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Determining the Function of Challenging Behavior

  • Assign roles
  • Review child description
  • Review observations
  • Review interview
  • Complete final page of interview
  • Determine functions of challenging behavior
  • Report to group
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Major Messages

  1. Challenging behavior communicates
  2. Children use behavior to access something or someone (obtain/request) or avoid something or someone (escape/protest)
  3. A behavior equation consists of triggers, the behavior, maintaining consequences, and the function
  4. The process of Functional Assessment is used to determine the function or purpose of challenging behavior