Addressing Challenging Behavior: Fu nctional Behavior Assessment and Positive Behavior Supports.
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Transcript of Addressing Challenging Behavior: Fu nctional Behavior Assessment and Positive Behavior Supports.
Challenging Behavior
Behavior that results “…in self-injury or injury of others, causes damage to the physical environment, interferes with the acquisition of new skills, and/or socially isolates the learner”
( Doss and Reichle )
Challenging Behavior in Children with Down syndrome
– Coe et al., (1990) and Dykens and Kasari (1997) found higher rates than typically developing children of:
• attention deficits• social withdrawal• noncompliance
– Compulsive like behaviors (e.g., arranging objects, repeating certain actions) (Evans & Gray, 2000)
– Talking to themselves (Glenn & Cunningham, 2000) – Problem behaviors associated with anxiety, depression, and
withdrawal increase with age (Dykens & Kasari, 1997; Einfeld, Tonge, Turner, Parmenter, & Smith, 1999).
Functional Behavior Assessment (FBA)
An FBA is designed to assess the causes of a student’s challenging behavior and to make recommendations on corresponding reports and subsequent behavioral intervention plans.
What do we do?
– A systematic method of assessment for obtaining information about the function of a problem behavior
– Identifies the variables that appear to lead to and maintain the behavior – function
– Used to help make a plan to increase appropriate behavior and decrease inappropriate behavior
5 Steps for Conducting an FBA
1. Identify challenging behavior in concrete and observable terms2. Collect information utilizing indirect assessments. 3. Utilize direct measures to collect data on the challenging behavior and
establish base-line levels. 4. Analyze data collected.5. Develop a hypothesis that describes why the behavior is occurring.
NOTE: Once the FBA is complete Develop recommendations and/or create a BIP to improve the
problem behavior. Implementation of a BIP. Evaluate the plan and modify as needed.
What constitutes problem behavior?What constitutes problem behavior?
May interfere with the student’s ability to learn (or the learning of others)
May be dangerous to a learner
May be dangerous to others
May place property at risk
May create a barrier to participation
May create a barrier to relationships
May be stigmatizing
Define the Problem in Observable and Measurable Terms
Must be observable, measurable, precise and not subject to interpretation
– What does the behavior look like (topography)– When does the behavior occur– Where does the behavior occur– With whom does the behavior occur– How often does the behavior occur
Identify Challenging Behavior in Concrete & Observable Terms
General descriptions
Concrete & Observable Descriptions
Student is aggressive
During lunch, when student doesn’t get his way, he hits other children
Student is disruptive
Student continuously calls out and makes inappropriate comments during math seat work
Student is hyperactive
Student continuously moves around on seat, plays with items on desk, and gets out of his seat w/o permission during reading activities 10
Questions To Be Answered
1. What are the antecedents of the challenging behavior (e.g., setting events that elicit the behavior)?
2. What are the consequences for the challenging behavior, which may reinforce it?
3. What does the student gain?4. What does the student avoid?
STEP THREE
Utilize direct measures to collect data on the challenging behavior and establish base-
line levels.
Direct Measures• Direct Measures
– Frequency– Duration– Latency– Intensity
• Scatter Plot - data during specific time intervals across the day
Scatter Plots
Questions to be answered…
• What is the intensity of the challenging behavior (e.g., frequency, duration, strength, etc.)?
• How does student’s challenging behavior compare to his or her peers?
• How does the student’s challenging behavior vary across settings?
Questions to be answered. . .
• What patterns of antecedent events and/or consequences are connected to the student’s challenging behavior?
• What is the student gaining or avoiding?• What are the antecedent events that elicit the behavior and
what are the consequences that reinforce the behavior (A-B-C’s)?
• Do skills and/or performance deficits contribute to the challenging behavior?
• Are setting events contributing to the behavior?
Functional Analysis
• Consists of the systematic manipulation of controlling variables to demonstrate the function of the behavior (O’Neill et al., 1997 as well as Iwata, Dorsey, Slifer, Bauman, & Richman, 1982).
• Functional analysis involves measuring rates of challenging behavior as a series of conditions are introduced.
Conduct Functional Analysis
• Manipulate different environmental events to see how behavior changes
• 4 specific conditions are evaluated
• Alone – test for automatic reinforcement
• Attention – test for socially mediated positive reinforcement
• Demand – test for socially mediated negative reinforcement
• Play – control for the three other test conditions
Examples of manipulations
– For a period of time do not deliver any attention while measuring behavior
– Then deliver high rates of high quality attention while measuring behavior
•Task Avoidance– Deliver easy then hard tasks, novel versus
maintenance items•Non-socially motivated
– Place the child in a variety of situations and observe the behavior
S: Setting Events
Biological/Physiological EventsSleeping, eating/diet, medication, toileting, health, presence of a specific disability
Environmental EventsPhysical events: e.g., temperature, noise, architecture Social events: e.g., staffing changes, previously occurring social interactions characterized by positive or negative valence), forgot favorite toy, number of people in room, changes in schedule
Specific Syndromes asa Setting Event
• McGee (1999) noted that the presence of a specific disability itself may in fact function as a motivating operation. – a decrease in the reinforcing value of attention in
individuals with autism– an increase in the reinforcing value of food in
individuals with Prader-Willi.
Down Syndrome as aSetting Event
• Wishart (1987) demonstrated children with Down syndrome have a tendency, even at an early age to engage in escape behavior
– Demonstrated children with Down syndrome have a propensity to engage in noncompliant behavior often taking the form of “cute” party tricks.
– Observed such behaviors during assessment tasks, particularly when the children were presented with slightly more difficult tasks.
– Thus, specifically in children with Down syndrome, there may be an increase in the reinforcing value of escaping demands and possibly an increase in the reinforcing value of attention.
E: Escape
Learners may display problem behavior in order to escape from, delay, or avoid, tasks and activities
Examples: work demands, chores, transitions to non-
preferred activities, etc.
A: Attention
Learners may display problem behavior in order to gain attention from adults or other students
Examples: parent/teacher attention, peer attention,
reprimands, praise, etc.
T: Tangible (Toys/Things)
Learners may display problem behavior in order to access preferred items
Examples: Preferred activities, toys, books, snacks, etc.
S: Sensory
• Learners may display problem behavior in order to access to or avoid sensory stimulation
Formulate a Written Positive Behavior Support Plan
• Rationale• Target Behaviors
– Behaviors to increase– Behaviors to decrease
• Hypothesized function of behavior• Antecedent Strategies• Reactive Strategies• Measurement• Implementation• Follow up
Target Behaviors
Include all behaviors to be addressed– Behaviors to increase– Behaviors to decrease
Must be operationally defined
Hypothesized Function of Behavior
• What is the hypothesized function?• How did you determine the function?
– MAS/FAST– ABC Data– Functional Analysis
Is Behavior due to Setting Events
• Biological – illness, lack of sleep, ear infection, menses, fatigue, allergies
• Environmental – noisy and/or crowded environment, negative interaction
Setting Event Checklist
• If you believe there is a relationship between setting events and challenging behavior:– List the setting events that are likely to affect challenging
behavior– Create a system where a caregiver identifies if a setting
event occurred on a give day– Refer to suggestions to address setting events to help to
decrease the likelihood of challenging behavior
Setting Event Checklist
Event 4/1 4/2 4/3 4/4 4/5 4/6
Didn’t get a good night’s sleep
Mom out of town
Allergies acting up
Can also report via telephone, fax, e-mail, text
Addressing Setting Events• Remove the setting event (e.g., ensure good
night sleep, medication is taken)• Neutralize the effect of the setting event (e.g.,
relaxation routine, provide food or medication, allow for a nap)
• Remove stimuli that occasion problem behavior when setting event present (e.g., change in schedule, reduce demands)
• Increased the rewards available for appropriate behavior when setting event present
Antecedent Strategies
Environmental changes that will decrease the likelihood of the target behavior occurring
Antecedent Strategies
• What can you do to set up the situation so problem behavior is less likely to occur?
• What can you do to set up the situation so appropriate behavior is more likely to occur?
Antecedent Strategies
General• Structured teaching environment• Clear and consistent expectations• Schedules and visual strategies• Alternate work and play activities• Intersperse active and quiet activities• Transitions should be short and organized• Catch the student being good• Know the triggers of the student’s behavior• Embed reinforcers
Offering Choices
Provide Choice of 2 options– may need visual cues– may need 2 preferences– shift to 2 non preferred
Examples– Would you like to play blocks or look at books?– Would you like your drink or snack first?– Would you like to pick up red blocks or blue blocks?
Offering Choices
Choices can be offered on where to do a task, when, with which materials, how, and with whom
Generally, forced choices (e.g.., “You can have the red or blue pencil”) produce more compliant behavior than “yes/no” choices (e.g.., “Do you want to get your pencil?”)
Preferred Item as a Distracter
Allow the child to engage in the activity using preferred materials
MarkersColored pencilsLaptopOverhead projectorColored paper
High Probability Requests• Identify high probability tasks• Identify low probability task• Request 2-3 high probability tasks followed by a low probability
task• REINFORCE• Utilize a fast pace of instruction
High Probability Requests
• Gain compliance on some high probability requests (mastered, easy, preferred tasks)
• Quickly ask for compliance on low probability request (new, harder, less-preferred)
• Variation: “Slam-the-door” technique
Pre-Specify Reinforcer
• Describe the reinforcer prior to making a request– “I can’t wait to go shopping this afternoon, first
let’s stop in the dry cleaner.”– “Lunch in the park is going to be so much fun!
We’ll go as soon as we go to the post office.”– “I have your favorite snack. Quick, let the doctor
check your throat.”
Collaboration
• Fill in some of the answers so that the child will have same sheet but not required to complete them all
• Provide child with opportunity to circle/highlight items that you will complete– Can build a “tolerance”, starting off with several
and then less and less over time
Antecedent Strategies
• Visual Schedules/First/Then• Token Systems/Classroom Management• Reminders and Rules• Count Down/Count Up• Social Stories• Power Cards
Visual Schedules
Step by step visual guide to completing tasks independently
List of activities that need to be completed in sequence
The visual pictures cue the person to perform each task in the sequence of activities.
Visual SchedulesSchedules need to be portable and easy to
access and use. Schedules should not be faded out as the
student “learns” their schedule. Pictures, words, colored-coded cards can be
used.
Visual Schedules
Can be used to represent a full dayCan be used for a partial day (morning than
afternoon)Can be indicated as a first___, then ____
Activity SchedulesAn activity schedule is a set of pictures or words that
cue a child to follow a sequence of activities.When mastered, the schedule helps children to be
more self directed and purposeful in home, school, and leisure activities.
With this visual cueing system, students move the picture of each task to the done envelope as it is completed.
Token Systems
• Reward Systems
▫ Student to earn “tokens” (any tangible object) that can be “cashed in” for a highly preferred activity/reinforcer
▫ Tokens earned based on identified target behaviors▫ Tokens can take many forms, Numbers, checks, words; Cartoon
characters; Puzzle pieces▫ ALSO serve as reminder of rules
Advantages of Token Economies• Immediate, unobtrusive delivery of reinforcers• Allows for delay of reinforcement• More and more frequent reinforcement can be delivered
and for a longer time• Ease of generalization• Greater individuality of reinforcement• Structures administrators attention and reduces
subjectivity• Allows for differential valuing of performance
Reminders and Rules
Visuals can be used to reinforce or remind students of
rules.Sit niceHands downQuiet mouthClose bathroom doorClean up
Contingent Reinforcement Procedures
• Important for parents/family members to be prepared to respond when the learner engages in appropriate behaviors.
• Important for parents/family members to know how to respond if the challenging behavior does occur.
Differential Reinforcement
Simply stated:– Systematically reinforcing one
response while simultaneously withholding reinforcement for another
Differential Reinforcement
• Differential Reinforcement of the Omission of the Behavior (DRO) = reinforcement is delivered when the child does not engage in the challenging behavior for a pre-specified period of time
• Differential Reinforcement of Alternative Behaviors (DRA) = reinforcement of behaviors that serve as alternatives to the difficult behavior (e.g., communicative alternative)– Communicative Replacements– Work behavior– Appropriate social behaviors
Differential Reinforcement (cont.)
• Differential Reinforcement of higher rates of behavior (DRH)= previous performance is monitored and then current performance is compared. If higher rates of behavior occur, reinforcement is delivered.
• Differential Reinforcement of lower rates of Behavior (DRL) = previous performance is monitored and then current performance is compared. If lower rates of behavior occur, reinforcement is delivered.
Antecedent Strategies based on Function of the Behavior
Escape/Avoidance• Enrich the task environment• Use an alternative mode of task presentation• Pair demand with a reinforcer• Teach an alternative communication response
– FCT• Use behavioral momentum
– High probability request sequence• Increased breaks
– Releasing from circle time or manipulative activities early
Antecedent Strategies based on Function of the Behavior
Attention
• Determine how frequently the learner gets attention for problem behavior (e.g., once every 10 minutes)
• Deliver attention to learner (in the absence of problem behavior) at a faster rate (e.g., every 8 minutes)
• Do not deliver attention for problem behavior
Antecedent Strategies based on Function of the Behavior
Tangibles• Giving increased access to favorite foods, toys,
clothing
– Increased access to preferred activities • Computers • Playing outside• Games• Magazines, books• Coloring• Video games
Antecedent Strategies based on Function of the Behavior
Sensory• Increased or decreased sensory input
– Increased Sensory Input • Jumping on a trampoline• Rolling on mats• Bouncing on a yoga ball
• Decreased Sensory Input• Remove from large groups• Remove from noisy areas
*** Must be done Antecedently only!! ***
Replacement Behavior
Teach a more appropriate behavior that serves the same function as the target behavior and is more efficient
Replacement Behavior
Tolerance for Delay• An intervention developed to help children maintain
participation in an undesirable activity for increasing lengths of time
• Waiting for a desirable activity for increasing lengths of time
Replacement Behavior
Communication • Build a functional language repertoire• Which of the following are functional language skills?
– Knowing the capitals and 50 states– Identifying all the colors– Counting to 100 by 10s– Requesting a drink– Rejecting a social offer– Choosing what to eat for lunch– Asking to take a break
Replacement Behavior
Functional Communication Training• Identify a new, alternative response that serves the same
function as the problem behavior
• The alternative response should result in greater reinforcement and more effective interaction with the environment
Antecedent Strategies
Examples of Replacement Behaviors (cont.)
Functional Communication Training• How to implement FCT
• Decide what alternative response you want to teach the learner to use instead of the problem behavior
• Determine when you will use the intervention• Teach the learner to use the alternative response form by
using prompts, and reinforcing each occurrence of the desired behavior
– Alternative response should require minimal response effort and access reinforcement across all environments
Discussion
Problem Behavior Replacement
Gagging = Drink Picture of a cup = Drink
Biting = “I need a break”” ____________ = “I need a break”
Spitting= “I want to play” ____________ = “I want to play”
Screaming = “It is too loud” ___________ = “It is too loud”
Antecedent Strategies
Reinforcement Systems
• Token System
– Sticker charts– Penny boards– Count up Count down
• Token Economy– Money
• DRO/DRA
Delivering Reinforcement
Rule 1: Cannot tell whether something is a reinforcer until try it and observe effect on the behavior.
Rule 2: What is a reinforce for one person may not be for another. Individualized.
Rule 3: To be effective, a reinforce must occur during or immediately after the behavior.
Delivering Reinforcement
Rule 4: Limited AccessRule 5: Reinforcement must be contingent if it is to be
effective. RE: First this, then that.Rule 6: When strengthening a new behavior, reinforce
frequently.Rule 7: Size of SR+ is big enough to keep student
motivated, but not to big for satiation
Reactive Strategies
Must follow ethical guidelines for behavior reduction
Fair Pair Rule
Least restrictive procedures
Preserve safety
Preserve dignity
Reactive Strategies
Extinction• Breaking a contingency between a response and a reinforcer
• Typically involves withholding the reinforcer contingent on the behavior targeted for reduction
• Extinction bursts are predictable and common and include:– increase in rate/intensity of responding
• If the behavior is reinforced during extinction it will re-occur at the greater rate and intensity
• Everyone must consistently implement the extinction protocol
Reactive Strategies
Extinction• Protocol must be maintained for a sufficient time• Desired behaviors may inadvertently be extinguished by failing
to provide adequate reinforcement• The learner must be kept safe without providing reinforcement• Respond without emotional reaction• Extinction induced aggression and spontaneous recovery are
possible• Reinforcement procedures should always be run with an
extinction procedure
Reactive Strategies based on the Function of the Behavior
Attention• Do not use the learner’s name
• No eye contact
• No yelling
• No lectures
• Limited “chasing”
Reactive Strategies based on the Function of the Behavior
Escape/Avoidance
• Learner is not allowed to elope from circle time
• Learner must complete presented task– Finish a puzzle– Complete a discrete trial – Clean up
• Learner must stay in the classroom
Reactive Strategies based on the Function of the Behavior
Tangible• Learner cannot access the item or activity that evoked the
problem behavior
– Learner may not have the lollipop they asked mom for
– Learner may not access materials on a high shelf that they climbed up to get
– Learner may not watch TV after pushing someone out of the way in order to access the remote
Reactive Strategies based on the Function of the Behavior
Sensory• Change the environment
– Remove items learner uses in a self stimulatory / inappropriate manner
• Block the behavior
• Move the learner to another area– e.g., move to the learner to a room without fluorescent light
Reactive Strategies
NYSED Requirements Relating to the Use of Behavioral Interventions and Supports
• Prohibit the use of corporal punishment
• Prohibit the use of aversive interventions, with limited exceptions
• Authorize the limited use of unlocked time out rooms where a student is observed by staff at all times when a student needs an area to safely deescalate, regain control and prepare to meet expectations to return to his or her education program
Reactive Strategies
NYSED Requirements Relating to the Use of Behavioral Interventions and Supports
• Authorize the use of reasonable physical force, including the use of physical restraints only in emergency situations in which alternative procedures and methods not involving the use of physical force cannot reasonably be employed
The State Education Department The University of the State of New York
Punishment
Prior to implementing any punishment procedures, there must be data documenting
attempts at behavior change using less intrusive procedures.
The determination to use punishment procedures should be made by an
intervention team involving input from parents.
Reactive Strategies
Punishment ProceduresPositive Punishment
– Decreases the future likelihood of a behavior occurring by adding an aversive stimulus to the environment
Reactive Strategies
Punishment ProceduresNegative Punishment
– Decreases the future likelihood of a behavior occurring by removing a reinforcing stimulus from the environment
• Time out• Response Cost
(i.e. late fees, traffic tickets, loss of tokens)
• Removing a preferred activity(i.e.TV, Dessert, Play time, Play date)
Reactive Strategies
Punishment Procedures Negative Punishment
Recommendations for time out from reinforcement
Should not exceed one minute per year of age Use of bathroom and drink must not be withheld Do not time out from an aversive event Child should be monitored (no attention) Release is contingent on absence of targeted problem
behavior or pre-selected criteria Document occurence and length of time out
Reactive Strategies
Punishment Procedures • Disadvantages
– Punishment induced aggression may occur– Can produce other side effects – Avoidance behaviors– Spontaneous Recovery is possible– Behavior may return with increased duration, frequency and
intensity – May be imitated by peers– Can cause people and settings to become conditioned punishers– Does not teach any new behavior– May cause learner to model our behavior– Professionals may opt to use this method and disregard using
reinforcement procedures
Implementation
• Clearly define how the plan will be implemented• Indicate specific steps• Identify who is responsible for implementing the plan• Identify necessary materials and data collection methods
Measurement
• How will the behavior be measured (What kind of data ?)
• Who will be taking the data?• How often will data be collected?• Who will analyze the data?• How often will the data be analyzed?• What is the criteria to determine the plan’s effectiveness?• Criteria for mastery
FAQ’s
• What should I do if the BIP works for a while, and then the problem behavior comes back?
• What if the BIP works in some situations and not others?
• What if a parent or teacher will not follow through with the BIP?
Functional Behavior Assessment Checklist
Identify behavior to be changed
Operationally define target behavior
Conduct Functional Analysis
Conduct an unstructured observation
Conduct a structured observation - record data (ABC, scatter plot)
Analyze data for patterns
Determine function and develop hypothesis
Formulate a Behavior Intervention Plan (BIP)