 |
Positive
Behavior Interventions and Support |
 |
Learner
Objectives
- This
workshop will teach you to:
Identify the steps of the process of PBS
- Describe
and select strategies that may be used to prevent challenging
behavior
- Identify
replacement skills that may be taught to replace challenging
behavior
- Identify
how to respond in a way that does not maintain or reinforce
challenging behavior
|
 |
“If
a child doesn’t know how to read, we teach.”
“If
a child doesn’t know how to swim, we teach.”
“If
a child doesn’t know how to multiply, we teach.”
“If
a child doesn’t know how to drive, we teach.”
“If
a child doesn’t know how to behave, we……
teach?… punish?”
“Why
can’t we finish the last sentence as automatically
as we do the others?”
–Tom
Herner (NASDE President ) Counterpoint 1998, p.2 |
 |
Brendan
– Before PBS |
 |
Brendan
– With PBS |
 |
Tim
– Before PBS |
 |
Tim
– With PBS |
 |
Importance
of PBS |
 |
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 |
 |
Hypotheses
Statements
- Triggers
of the challenging behavior
- Description
of the challenging behavior
- Responses
that maintain the challenging behavior
- Purpose
of the behavior
|
 |
Hypotheses
Statements
- Brendan
is likely to tantrum (prolonged whining, crying, screaming,
and dropping to the ground) and then sometimes will
throw an object when someone places a demand to go somewhere.
When he tantrums and/or throws objects, he is sometimes
allowed to continue playing or the transition of going
somewhere is prolonged. This results in temporarily
escaping the transition or delaying “going somewhere.”
|
 |
Brendan’s
Behavior Equation
Triggers:
- Walking
to car from house
- Walking
from car to public place
- Demand
is placed to go to next “activity”
- Change
in routine
Setting
Event:
Behaviors:
- TANTRUMS:
cries then yells and screams, throws self onto ground,
sometimes throws objects
Function:
Responses:
- Sometimes
allowed to continue what he was doing a bit longer
- Verbal
coaxing
- Physically
helped after a bit of his tantrum
|
 |
Not
Sure About the Hypothesis?
- What
would make the challenging behavior stop? Is it something
you would provide or allow the child to access? Or is
there something to remove? Or can you allow the child
to leave?
- If
still unsure, collect more data in the same context
- Some
challenging behavior may have the same form, but serve
multiple functions.
- Some
challenging behaviors may begin around one function
(e.g., escape) and continue to serve another function
(e.g., gain attention)
|
 |
Activity |
 |
Think
Outside the Box: |
 |
There
are Many Variables to Explore
Health:
Trauma, Illness, Stamina, Medication...
Play:
Toys, Level of play, Opportunities, Choice, Expectations...
Learning Environment:
Schedules, Room arrangement, Materials, Adaptations,
Resources, Predictability...
Instruction:
Transitions, Cues, Prompts, Supports, Accommodations...
Home & Family:
Routines, Resources, Siblings, Environment, Respite,
Predictability, Extended family...
Outings/Events:
Places family goes, Activities...
Friends:
Shared interests & experiences, Relationships...
Interactions:
Communication to the child, Emotional support, Attachment...
|
 |
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 |
 |
Support
Plan
- Behavior
Hypotheses - Purpose of the behavior, your best
guess about why the behavior occurs
- Prevention
Strategies
- Ways to make events and interactions that trigger
challenging behavior easier for the child to manage
- Replacement
Skills – New skills to teach throughout the
day to replace the challenging behavior
- Responses
- What adults will do when the challenging behavior
occurs to ensure that the challenging behavior is not
maintained and the new skill is learned
|
 |
Prevention
Strategies
- How
can the environment be changed to reduce the likelihood
that challenging behavior will occur?
- What
can be done to make challenging behavior irrelevant?
- What
procedures can I select that fit in the natural routines
and structure of the classroom or family?
|
 |
Prevention
Strategies (Cont.)
- How
can I build on what works?
- What
can be done to help the child not respond to the trigger
or changes the trigger so it does not cause challenging
behavior?
|
 |
Observation
Vignette #1 |
 |
Observation
Vignette #2 |
 |
Escape
(e.g., activity, demands, social interaction)
Sample
Prevention Strategies
- Modify
expectations, materials, instructions, seating arrangements,
ways child is expected to respond, and etc. to reduce
the need for escape
- Use
choice, manipulatives, peer support, child interests,
etc. to reduce child desire to escape
- Reduce
distractions or competing events, materials, etc. that
may contribute to desire to escape
|
 |
Escape
(e.g., activity, demands, social interaction)
Sample
Prevention Strategies (continued)
- Use
visual supports, activity schedules, social stories,
timers, first/then boards, selecting the reinforcer
prior to activity, etc. to support child to engage in
undesired activity, interaction, or demands
- Use
self-management to assist child in completing difficult
activities or approaching avoided social interactions
|
 |
Obtain
(e.g. attention, object, activity)
Sample
Prevention Strategies
- Modify
activities, materials, instructions, response mode,
task length or other modifications that will reduce
need to request help
- Provide
peer support, scheduled interaction with adult, more
frequent attention or other strategy to reduce need
to request attention
- Use
activity schedule, social stories, visual schedules,
or scripts to provide child with information on when
access to desired object, event, interaction, or activity
will occur
|
 |
Obtain
(e.g. attention, object, activity)
Sample
Prevention Strategies continued
- Use
completion contingency, first/then schedules, etc. to
support child in understanding when access will occur
- Use
choices, manipulatives, child interest, etc. to distract
or support child during times when access can not be
provided
- Use
timers or reinforcement delay signal to let child know
when access to activity, object, attention, etc. will
occur
|
 |
Preventions
to Minimize the Affect of the Setting Event
- Provide
the child with a calming or desirable activity
- Decrease
demands on the child
- Increase
attention or comfort
- Offer
a chance to rest or cuddle
- Provide
additional supports for routines and activities
(e.g., transition warnings, visuals, adult assistance)
|
 |
Prevention:
Choice
- Choice
can be offered using photographs, visuals, or actual
objects
- When
used as a prevention strategy, choices must be offered
explicitly and personally to the child
- Choices
should represent options of desirable activities or
materials
|
 |
Show
real items or photograph of items to child to allow to make
a toy choice. |
 |
Circle
Choices |
 |
Song
Choices |
 |
Center
Choices |
 |
Prevention:
Safety Signal
- Make
eye contact and gain the child’s attention
- Provide
a warning to the child (e.g., 5 more minutes or 3 more
times)
- Give
the child several countdowns (e.g., 2 more times, 1
more time, all done)
- State
the ending activity and activity to follow (“5
more minutes, then clean-up”)
- Use
visuals, photographs, or object to represent next activity
- May
use timer for countdown
|
 |
Safety
Signal |
 |
Prevention:
Visual Schedule
- Use
photographs or line drawings
- Depict
the major activities or steps of an activity
- Assist
the child in removing the visual once the activity is
complete
|
 |
Visual
Object Schedule |
 |
Visual
Photo Schedule |
 |
Mini
Schedule with Line Drawings |
 |
First/Then
Photo Schedule |
 |
First/Then
Visual Schedule |
 |
First/Then
Mini Schedule |
 |
Prevention:
Visual Activity Analysis
- Provide
visuals of the steps used within an activity (e.g.,
art project)
- Child
can use the visuals to complete activity independently
- Some
children may need to remove each visual when steps are
completed
|
 |
|
 |
|
 |
Prevention:
Visual Guidance
- Provide
visuals for children that highlights boundaries
- Use
feet for line-up (each child stands on a set of foot
prints), carpet squares for circle time, mats for block
structures
|
 |
Visual
Guidance |
 |
Activity
Turn-Taking Cue |
 |
Prevention:
Social Stories
- Social
stories provide a script for the child about social
situations and expectations
- The
story is written from the child’s perspective
- The
story includes descriptive, perspective, and directive
sentences
- The
story must match the child’s symbolic and receptive
communication level
|
 |
Prevention:
Self-Management
- Identify
an observable behavior that the child will self-manage
- Visually
display behaviors for the child
- Provide
instruction to the child on the targeted skill
- Give
child a mechanism to monitor engagement in the behavior
through a checklist or chart
- Provide
positive attention to the child for engaging in the
behavior and using the self-monitoring system
|
 |
I
can be a Super Friend
I
can join my friends and play nicely. ________
I
can take turns nicely. ________
I
can go with the flow. ________
I
can stop, think, and do. ________
Date:
________ |
 |
Support
Plan
- Behavior
Hypotheses - Purpose of the behavior, your best guess
about why the behavior occurs
- Prevention
Strategies - Ways to make events and interactions that
trigger challenging behavior easier for the child to
manage
- Replacement
Skills – New skills to teach throughout the day
to replace the challenging behavior
- Responses
- What adults will do when the challenging behavior
occurs to ensure that the challenging behavior is not
maintained and the new skill is learned
|
 |
Teaching
Replacement Skills
- Teach
alternative behavior to challenging behavior
- Replacement
skills must be efficient and effective (i.e., work quickly
for the child)
- Consider
skills that child already has
- Make
sure the reward for appropriate behavior is consistent
|
 |
Functional
Equivalence
- Identify
an acceptable way that the child can deliver the same
message
- Make
sure that the new response is socially appropriate and
will access the child’s desired outcome
- Teach
the child a skill that honors that function of the behavior
(e.g., if child wants out of activity, teach child to
gesture “finished”)
|
 |
- Child
told sibling gets a turn
- Child
yells, kicks, throws
- Parent
gives child another turn
- Child
told sibling gets a turn
- Child
asks for one more turn
- Parent
says "one more turn, then your brother's turn" and
gives turn
|
 |
- Child
can't make toy work
- Child
cries and bangs head
- Adult
comes running and hugs child
- Child
can't make toy work
- Child
gestures or asks for hug/help
- Adult
hugs and helps
|
 |
Discussion
Activity
- Child
asked to join the circle
- Child
screams and resisits
- Teacher
lets child out of activity
- Child
asked to join the circle
- Child
gestures "all done"
- Teacher
lets child out of activity
|
 |
When
You Can’t Honor the Function of the Challenging
Behavior…
- Teach
tolerance for delay in achieving the reinforcer (e.g.,
help the child stay engaged by giving a signal about
how long to hang in “two more songs, then all
done”)
- Provide
choices (“You can wear goggles or the visor hat,
but we need to wash your hair.”)
- First,
then contingency (“First, ride in car. Then, playground.”)
|
 |
When
You Can’t Honor the Function of the Challenging
Behavior…(Continued)
- Provide
preferred items as distraction (“Sit in car seat;
you can have teddy bear or you can have blanket.”)
- Teach
child to anticipate and participate (e.g., provide a
transition warning and a visual schedule so the child
can anticipate the transition and actively participate)
|
 |
Escape
(e.g., activity, demands, social interaction)
Possible
Replacement Skills
- Request
break
- Set
work goals
- Request
help
- Follow
schedule
- Participate
in routine
- Choice
- Self-management
- Say
“No”
- Say
“All done”
- Identify
and express feelings
- Use
supports to follow rules
- Anticipate
transitions
|
 |
Obtain
(e.g. attention, object, activity)
Possible
Replacement Skills
- Follow
schedule
- Participate
in routine
- Self-management
- Request
help
- Teach
delay of reinforcement
- Request
attention
- Choice
- Ask
for a hug
- Ask
for a turn
- Ask
for item
|
 |
Teaching
Replacement Skills: How to Teach
- Teach
skills intentionally using planned procedures
- Teach
replacement skills during time the child is not having
challenging behavior
- Teach
throughout the day
|
 |
Designing
Replacement Skill Instruction Procedures
- Select
a skill to teach
- Select
a method of instruction
- Follow
steps of instructional procedure systematically
- Teach
throughout the day
|
 |
Most-to-Least
Prompting
- Full
physical assistance
- Partial
physical assistance
- Verbal
direction
- Natural
trigger for the skill
|
 |
Most-to-Least
Example:Say “All Done” with Gesture
- Physically
assist child using hand-over-hand to gesture “all
done”: Do this for 8 days in a row.
- Partially
assist child by placing hands on elbow to prompt to
gesture “all done.” Do this for 8 days.
If child does not respond, provide full physical assist
as correction.
- Model
gesture and verbally direct child by stating “say
all done”; do this for 8 days in a row. If child
does not respond, provide partial assistance. If child
does not respond to partial assistance, provide full
physical assistance.
- Ask
child “What do you want?” If child does
not respond, provide verbal direction with gesture for
“all done.” If child does not respond to
verbal with gesture, provide partial physical. If child
still does not respond, provide full assistance.
|
 |
Least-to-Most
Prompting
- Natural
trigger for the skill
- Verbal
or visual prompt
- Gestural
or model prompt
- Physical
guidance
|
 |
Least-to-Most
Example:Teaching to Sit in Car Seat
- Look
at child with expectation to sit
- If
child doesn’t sit, state “sit please”
- If
child doesn’t sit with verbal direction, gesture
to sit by patting car seat while stating “sit
please”
- If
child still doesn’t sit, physically guide child
to car seat and praise for sitting (e.g., “thank
you for sitting”)
|
 |
Modeling/Request
Imitation
- Arrange
the environment to capture the child’s attention
or interest
- Provide
a command (e.g., “Tell me what you want”)
and wait 4-6 seconds
- If
the child does not respond correctly, provide a model
“say _______” and wait 4-6 seconds
- If
the child responds correctly, provide item/request with
a verbal expansion. If the child does not respond, provide
item/request with a model.
|
 |
Modeling/Request
Example:Teaching to Say “Help Me Please”
- Have
art materials available as a choice for child (one being
a closed bottle of glue). After child goes to the area
and gets frustrated with opening the glue bottle, look
expectantly and say “what?”, then wait 4-6
seconds
- If
child is still frustrated, say, “Tell me what
you want” and wait 4-6 seconds
- If
child says “help me please”, provide help
with opening the glue and verbally expand on what was
said, “You want help opening the glue. I’ll
help you.”
- If
the child doesn’t respond, provide model. “Say,
help me please” and then look expectantly at her.
Delay for 2-4 seconds. If child says “help me
please”, provide help and say “o.k., I’ll
help you open the glue.”
- If
child still doesn’t say “help me please”
repeat model & then help child.
|
 |
Teaching
Replacement Skills: When to Teach
- Teach
skills intentionally using planned procedures
- Teach
replacement skills during time the child is not having
challenging behavior
- Teach
throughout the day
|
 |
Teaching
Request Help |
 |
New
Skill: Transition to Breakfast |
 |
Replacement
Skills Cue Cards |
 |
Social
Skills Instruction
- Determine
the skill to be taught, be specific (what does the behavior
look like?)
- Ensure
that opportunities to teach and practice skill are available
- Decide
on the method of instruction (e.g., role play, prompt
and praise, etc.)
- Teach
skill
- Provide
opportunities to practice skill
- Reinforce
skill use in natural contexts
|
 |
Support
Plan
- Behavior
Hypotheses - Purpose of the behavior, your best guess
about why the behavior occurs
- Prevention
Strategies - Ways to make events and interactions that
trigger challenging behavior easier for the child to
manage
- Replacement
Skills – New skills to teach throughout the day
to replace the challenging behavior
- Responses
- What adults will do when the challenging behavior
occurs to ensure that the challenging behavior is not
maintained and the new skill is learned
|
 |
Response
to Challenging Behavior
- Responding
in a way that will make challenging behavior ineffective
- Make
sure rewards for appropriate behavior are equal to or
exceed rewards for challenging behavior
|
 |
Escape
(e.g., activity, demands, social interaction)
Possible
Replacement Skills
- Redirect/cue
to use appropriate “new replacement skill”
and then allow escape
- Cue
with appropriate prevention strategy
- State
“exactly” what is expected
- Offer
alternatives
- Use
“wait-time”
- Praise/reinforce
when replacement skill is performed
- Respond
in a way that does NOT maintain challenging behavior
|
 |
Obtain
(e.g. attention, object, activity)
Possible
Replacement Skills
- Redirect/cue
to use appropriate “new replacement skill”
- Cue
with appropriate prevention strategy
- State
“exactly” what is expected
- Offer
choices
- Use
“wait-time”
- Praise/reinforce
when replacement skill is performed
- Respond
in a way that does NOT maintain challenging behavior
|
 |
Group
Activity: Discuss Strategies Used to Support Gabby |
 |
Safety-net
Procedures
- If
a child is in danger of harming himself or others, you
must first be concerned about safety
- You
may hold a child or remove a child from the situation
to keep children safe
- Safety-net
procedures may be planned for children who have a history
of dangerous outbursts
- Safety-net
procedures only keep children safe, they do not change
behavior.
- Safety-net
procedures are only appropriate when there is also a
full behavior support plan or intention to develop a
plan
|
 |
Major
Messages
- The
behavior support plan includes four parts: behavior
hypotheses, prevention strategies, replacement skills,
and new responses
- Hypotheses
statements describe the triggers, challenging behavior,
maintaining consequences, and function
- Prevention
strategies are used to soften the triggers of challenging
behavior
- Replacement
skills (to replace challenging behavior) are taught
systematically and throughout the day
|