This  product  was  developed  by  Florida’s  Positive  Behavior  Support  Project  through  the  University  of  South  Florida,  Louis  de  la  

Parte  Florida  Mental  Health  Institute  funded  by  the  State  of  Florida,  Department  of  

Education,  Bureau   of  Exceptional   Education  and  Student  Services,  through  federal  assistance  under  the  Individuals  with  

Disabilities  Education  Act  (IDEA),  Part  B.

Presented by: Lindsey Slattery

An Evaluation of Self-Management to Increase On-Task Behavior with Individuals Diagnosed with Attention-Deficit/ Hyperactive Disorder

Negative Outcomes

• School– Difficulties completing tasks– Poor or limited organization skills– Disruptive behavior– Off-task behavior– Poor social skills

Negative Outcomes

• Home– Oppositional and aggressive behavior– Off-task behavior– Poor sleep patterns– Strained family relations

Negative Outcomes

• Adulthood– Work difficulties– Frequent job changes– Difficulties in interpersonal relationships– Issues with tobacco use, substance abuse,

and comorbid psychiatric disorders

Pharmacological

• Stimulant medication• Non-stimulant medication

Non-pharmacological

• Working memory training• Neuro-feedback• Parent training• Daily report cards• Token reinforcement • Peer mediated reinforcement• Peer tutoring • School-home notes • Self-Regulation

Interventions

Self-Regulation Interventions

• Self-monitoring (Amato-Zech & Gardner, 2010)

• Self-reinforcement (Olympia et al., 1994)

• Self-management (Axelrod, Zhe, Haugen, & Klein, 2009) - Evaluate accuracy of one’s own recording and

compare to someone - Reinforcement is contingent on accuracy of

self-evaluations

Why Self-Management?

• ADHD is largely a deficit in self-regulated behavior

• Individuals with ADHD have impaired executive functions that impair their ability to self-manage

• Self-management can– Teach skills that address these deficits– Facilitate more independent living– Require less parental/adult involvement

Steps to Using Self-Management

• Establish prerequisite conditions• Define target behavior • Design procedures and forms• Teach• Monitor data• Conduct maintenance and follow-up assessment

Self-Management within Schools

• Tier 2 – Social skills groups– Academic groups (e.g., reading)

• Tier 3– On-task behavior– Organizational skills– Task completion– Academic accuracy, productivity, engagement

Taking what we know works in schools to the home…

• Intervene on unaddressed academic- or school-related issues at home

• Enhance collaboration/communication between schools and families

• Provide families with tools to make their child successful at home and subsequently more successful at school

Self-Management for Homework Behavior

Axelrod, Zhe, Haugen, & Klein (2009)• Participants: 4 adolescent males, 1 adolescent

female• Setting: Residential treatment program for

adolescents with significant problem behavior• Measures: On-task behavior, Incomplete homework

assignments• Procedure: Self-monitoring – 3-min interval– 10-min interval

• Results:

Purpose of Current Study

• Examine the effectiveness of using a self-management intervention to increase the on-task behavior of children diagnosed with ADHD

• Extend the research to examine the effectiveness of using a self-management intervention with children with ADHD in a home setting

• Extend the research to target a variety of problematic routines

Method

ParticipantsTommy, 11 yr old• Dropped from

Gifted program• Victim of

bullying

David, 9 yr old• Tantrums• Problems sleeping• Prescribed

Focalin

Johnny, 12 yr old• Removed from

school• Comorbid

diagnosis-Diabetes

•Setting§Participants’  homes

Method Cont…

• Dependent Variable:– Target Routines

§ Tommy: Homework§ David: Night time shower§ Johnny: Leisure reading

– On-Task Behavior§ Behavior Observation of Student in Schools (BOSS)

code§ Passive engagement, active engagement, absence

of off-task behavior§ Individualized by using examples

Homework: getting his homework materials together, completing his homework and having his parents check his homework to make sure it was correct.

On-Task• Silently reading • Looking at the computer screen• Asking parent a question related to the assigned

homework• Clicking the mouse to answer questions/advance

the screen on the appropriate site • Writing notes or answers • Turning the pages of a school book/journal• Speaking out loud about the academic work• Going to the bathroom• Eating a snack

Off-Task• Out of seat during homework time (except for

bathroom or bringing homework to parents to check)

• Playing a video game/computer game during homework time

• Playing with the computer mouse/keyboard when the homework is not on the computer

• Playing with pen/pencil• Spinning round in the chair• Talking to others about anything other than asking

for help on the current homework assignment• Singing/making loud noises• Complaining/whining • Looking away from the task at hand for more than

5 sec

Shower: getting his shower materials (e.g., towel) and pajamas together, taking a shower, getting dressed and taking his dirty clothes and towel to the laundry room.

On-Task• Standing in front of his dresser• Standing in the shower• Washing his hair• Washing his body• Carrying his clothes to the laundry

room• Drying his hair or body• Getting undressed• Getting dressed

Off-Task• Playing on the computer• Running around the house• Arguing with his parents• Screaming/crying • Laying on the floor

Reading: getting his book and writing materials (e.g., paper and pen) together, reading his book, and

writing a summary of what he had read

On-Task• Silently reading• Picking out his book• Gathering his journal and pen• Turning the page• Writing in his journal• Going to the bathroom

Off-Task• Drawing • Playing with the pen/pencil• Getting up from the table• Playing with the book• Talking to his mom/brother about

anything other than the current book• Arguing with his mom• Looking away from the book/journal

for more than 5 sec• Sitting with his head down/on the

table

Method Cont…

• Data Collection- Percent of total time spent on-task

§ Time spent on-task / Total duration of the routine X 100

- Duration of the routine§ Measured from the beginning to ending of the

routine

Method Cont…

- Accuracy (Child’s implementation)§ Below 80% = Retraining§ Tommy M = 97.5%, David M = 83.3%, Johnny M = 100%

- Treatment Fidelity (Parent implementation)§ Tommy = 4 sessions, David = 9 sessions, Johnny = 3 sessions§ M = 96.9%, David M = 100%, Johnny M = 100%

- IOA § 33% of baseline, 33% of intervention conditions§ Percent of time on-task:

• Tommy M = 95.8%, David M = 80.5%, Johnny M = 100%

§ Duration:• M = 100%

Child Version

1. I think the self-management intervention was beneficial and helped me stay on-task.

2. The self-management intervention was easy to learn.

3. The self-management intervention was easy to use.

4. I would be willing to use the self-management intervention in other setting such as school.

5. I would recommend the self-management intervention to other kids.

Parent Version

1. I think the self-management intervention was beneficial to my child.

2. The self-management intervention was easy to learn.

3. The self-management intervention was easy to use in the home.

4. I would be willing to continue using the self-management intervention in my home.

5. I would recommend the self-management intervention to other parents.

Methods Cont. • Social Validity

1-­‐strongly  disagree 2-­‐ disagree 3-­‐undecided 4-­‐agree 5-­‐strongly  agree

Method Cont…

• Experimental Design– Multiple baseline across participants– Evaluate the effects of a self-management

intervention

Method Cont…

• Procedures– Initial interview– Baseline

§ Behave as they normally would§ Preference assessment

– Training§ Participants

• 7 steps• Mastery = 90% or more for 2 consecutive sessions

§ Parents• 7 steps• Mastery = 100% for 2 consecutive sessions

Participant Training1. Provide participant with a rationale for the use of a self-

management intervention.2. Provide an operational definition of the target behavior (on-task

behavior) and provide examples.3. Describe the self-management procedure and introduce the self-

management form.4. Have the participant describe the self-management procedure to

the researcher to ensure understanding.5. Model the procedure for the participant.6. Allow time for the participant to rehearse using the procedure.• Participant will view videos from earlier baseline sessions to

practice identifying the target behavior.• Participant will practice using the self-management form to

record occurrences of on-task or off-task behavior.7. Provide feedback accordingly.

Parent Training1. Provide an operational definition of the target behavior (on-task behavior)

and provide examples.2. Introduce and provide instructions on the use of the self-management form.3. Allow the parent time to practice using the self-management form.• Parents will view videos from earlier baseline sessions to practice

identifying the target behavior.• Parents will practice using the self-management form to record

occurrences of their child’s on-task or off-task behavior.4. Provide instructions on determining accuracy scores.5. Provide instructions on delivering the appropriate form of feedback and

preferred items depending on the accuracy score achieved.6. Allow the parent time to practice comparing two self-management forms to determine an accuracy score and allow time to practice providing feedback and preferred items if earned. 7. Provide the parent with feedback accordingly.

Method Cont…

– Self-Management 3 min variable interval§ Auditory beep on average every 3 min§ Parents conducted accuracy checks

• 100% accuracy = praise and reward• Less that 100% = feedback• 3 consecutive sessions at 80% or more on-task = interval

was faded

– Self-Management 8 min variable interval§ Auditory beep on average every 8 min§ Accuracy checks, feedback and rewards stayed the

same

Method Cont…

– Self-Management plus Reinforcement§ Occurred if increase in on-task behavior was

not observed§ Reward contingent on accuracy and change in

on-task behavior• 100% accuracy• 80% or more on-task behavior

0

20

40

60

80

100

Baseline Self-Man 3-min

Self-Man 8-min

Tommy, homework

2 week follow up

0

20

40

60

80

100

Percent

of Time

On-Tas

k

Self-Man 3-min

Self-Man + Sr

David, nighttime shower

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

0

20

40

60

80

100

Sessions

2 week follow up

Johnny, leisure reading

Accuracy

On-task Behavior

Figure 1. Percentage of on-task behavior data is displayed above for Tommy, David, and Johnny across all phases of the study. Accuracy data scores are also displayed for all three participants.

0

20

40

60

80

Baseline Self-Man 3-min

Self-Man 8-min

2 week follow up

Tommy, homework

0

20

40

60

80

Durati

on of

Routin

e (min.) Self-Man 3-

minSelf-Man +

Sr

David, nighttime shower

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 220

20

40

60

80

Sessions

2 week follow up

Johnny, leisure reading

Figure 2. Duration of target routines data is displayed above for Tommy, David, and Johnny across all phases of the study.

Child Version

1. I think the self-management intervention was beneficial and helped me stay on-task.

2. The self-management intervention was easy to learn.

3. The self-management intervention was easy to use.

4. I would be willing to use the self-management intervention in other setting such as school.

5. I would recommend the self-management intervention to other kids.

Parent Version

1. I think the self-management intervention was beneficial to my child.

2. The self-management intervention was easy to learn.

3. The self-management intervention was easy to use in the home.

4. I would be willing to continue using the self-management intervention in my home.

5. I would recommend the self-management intervention to other parents.

1-­‐strongly  disagree 2-­‐ disagree 3-­‐undecided 4-­‐agree 5-­‐strongly  agree

• Parents: Tommy M = 5, David M = 4.6, Johnny M = 5

• Participants: Tommy M = 5, David M = 2.8, Johnny M = 5

Discussion

• Benefits of Self-Management- Effective at increasing on-task behavior- Intervals can effectively be faded- Duration of the target routine may decrease

as a result of effective self-management- Perceived overall as an easy and acceptable

intervention by participants and parents

Discussion Cont...

• Self-management plus reinforcement may be needed for some children

• Limitations– Lack of long term maintenance data– No fading of tangible rewards– Low amount of participants

Future Directions

• Target a wider range of participants• Examine different methods of fading

self-management intervals• Examine different methods of fading

tangible rewards• Collect long term maintenance data

Thank you!Lindsey Slattery

Lslattery@mail.usf.edu

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