friday, march 12, 2010 carol ann davis, edd university of washington cadavis1@uw

Addressing the Social and Behavioral Needs of Students with Autism and Other Developmental Disabilities

Friday, March 12, 2010Carol Ann Davis, EdDUniversity of [email protected]

Characteristics of Positive Behavior Support Assessment-based: Interventions directly linked to

environmental influences and a hypothesis concerning the function of the problem behavior.

Comprehensive plans, usually involving multiple interventions

Proactive, involving teaching alternative skills and adapting the environment.

Emphasizes lifestyle enhancement and inclusive settings as both the context for and long-range goals of intervention.

Characteristics of Positive Behavior Support (cont.)

Reflects person-centered values that honor the dignity and preferences of the individual.

Designed for use in everyday settings using typically available resources.

Broad view of intervention success that includes(a) increases in the use of alternative skills, (b) decreases in the incidence of challenging behavior, and (c) improvements in quality of life.

Conduct Assessments

Assessment of the Environment

Assessment of Instructionand Adult - Child Interactions

Assessment ofAntecedents

and Consequences

Increase in Teacher Time

and Level of Intrusiveness Explic

it

I

mplicit

Evaluate the Environment (Environmental Checklist)

Environmental

Can all of the children be seen?

Can all of the children see you or other instructional materials?Is the noise distracting to children?Is there enough light in the work areas?Do the children seem to be affected by the number of children in the area?Do the children seem to be affected by the number of adults in the area?Is the temperature in the room comfortable?Are there areas which may be visually distracting to the children?

Programmatic

Is there a schedule for the classroom?

Does the schedule reflect varied activities (i.e., quiet/loud, active/passive, etc.)?Are transitions planned and time allotted?Are the materials appropriate for the age group?Have material been rotated within the last two weeks?Are there enough materials for all children to be actively involved?

Changes in the Environment (Interventions)

Visual supports Arranging the room (defining specific

areas in the room) Limiting the number of children in an

area Zone staffing Post and teach rules and procedures Use novel materials or rotate materials

Instructional ChecklistIs the ratio of praise statements to negative statements at least 5 to 1?Does the instruction occur immediately prior to requesting the child to perform a new or not yet mastered task?Is the difficulty of the task set slightly above the child’s assessment skill level?Does the instruction provide adequate rate of success?

Are directions for the activity clear?

Are the tasks age-appropriate and functional?

Have preferences been incorporated into the instruction?

Is feedback occurring for incorrect responses?

Is feedback occurring for correct responses?

Are you withholding reinforcement for inappropriate behavior?

Strategies to Influence Behavior by Changing the Instruction

Content Include individual child preferences Break the tasks into simple steps Make the task meaningful and functional

Presentation Shorten the length of the task Provide choices Insure child success (errorless learning) Vary the difficulty of the tasks (intersperse mastered with

new) Provide unsolicited attention

Obtain DesirableEvents

Avoid/EscapeUndesirable Events

Internal External Internal External

Attention Objects/Activities

Attention Objects/Activities

• Rhythmic rocking• Endorphin release• Visual stimulation

• Smiles, hugs• Frown,scolding• Surprise

• Food• Preferrred activity• Money

• Sinus pain• Skin irritation• Hunger

• Smiles, hugs• Frown,scolding• Surprise

• Difficult tasks• Change in routine• Interruption of desired activity

3

What is a FBA?

A process that: Defines the target behaviors Determines the environmental events and factors that

contribute to challenging behaviors Identifies the antecedents and consequences that occur

before and after the challenging behaviors Hypothesizes the function or purpose of the

challenging behaviors Provides direction for developing appropriate and

effective positive interventions

4

FBA is a process in which many instruments may be used to gather information

Reviewing existing documents Interview Scale or Screening Instruments Scatterplot Direct Observation Tools Environmental Manipulation

4

Introduction of Case StudyNick is a 8 year old boy who attends a local school. He is in a self-contained classroom with students with a variety of severe disabilities. Nick was diagnosed with autism at 2.5 years old. He has limited verbal skills but will use “I want …” frequently to request items or people. Nick loves to fidget with action figures and likes to listen to music. Nick likes to verbally label pictures and look at books during academic times. Nick has demonstrated significant challenging behaviors including head-banging (fist to temple, fingers to bridge of nose), other bodily injury (knocking knees together, banging wrists together, banging wrists on table, biting wrists), object banging (using multiple objects to bang against head), and aggression towards others (biting, kicking). Nick lives at home with three sisters, mother, and father. His mother drives him to and from school as Nick has been demonstrating self-injurious behaviors while on the bus. His mother reports that she is seeing similar behaviors at home but not with the same intensity.

Existing Written Documents

Medical records Previous IEP/IFSP Social Work/Counseling Reports Reports from previous service providers

5

What events do I need to consider when I begin an intensive FBA?

Setting Events Conditions that increase the likelihood that

problem behavior will occur. They can be: Removed in time from the behavior (e.g., the child

wakes up late, is rushed through breakfast, and hurried out the door to daycare two hours before she refuses to clean up her toys)

In close proximity to the behavior (e.g., the child has a block taken from him immediately prior to hitting another child in that center; student has a bad interaction in the hallway prior to screaming at the teacher) Example

An ongoing situation or state (e.g., the student is extremely fatigued due to a cold and not sleeping well the night before).

6-8

Setting Event Checklist Case Study

9/12 9/13 9/14 9/15 9/16 9/19 9/20 9/21 9/22

Did not sleep at least 6 hours X X X X

Does not watch TV in the morning X X X X

Did not access lunchbox at lunch X X X

Late to school X X X X

6-8

9/12 9/13 9/14 9/15 9/16 9/19 9/20 9/21 9/22

Did not sleep at least 6 hours X X X X

Does not watch TV in the morning X X X X

Did not access lunchbox at lunch X X X

Late to school X X X X

6-8

Another Example

6-8

Setting Events

Bad interaction with family previous to school Sick, Hungry, Tired Was reprimanded in class and privilege taken

away

Advantages DisadvantagesIdentifies events that may influence whether or not a behavior will occur

No information regarding function, or frequency of behavior

Helps identify sources of variability in the child’s performance

No information on history or prior intervention outcomes

6-8

Motivation Assessment Scale

A 16-item survey that assists in developing a hypothesis about the function of the problem behavior

http://www.monacoassociates.com/mas/index.html

Advantages DisadvantagesEasy and quick to use Information may or may not be

reliableEasy to understand

Provides information regarding developing a hypothesis for the function of the behavior

9-10

Motivation Assessment Scale

Questions Never

0

Almost Never

1

Seldom

2

Half Time

3

Usually

4

Almost Always

5

1. Would the behavior occur continuously if this child was left alone for long periods of time?

Never

0

Almost Never

1

Seldom

2

Half Time

3

Usually

4

Almost Always

5

2. Does the behavior occur following a command to perform a difficult task?

Never

0

Almost Never

1

Seldom

2

Half Time

3

Usually

4

Almost Always

5

3. Does the behavior occur when you are talking to other persons in the room?

Never

0

Almost Never

1

Seldom

2

Half Time

3

Usually

4

Almost Always

5

4. Does the behavior ever occur to get a toy, food, or game that he or she has been told that he she can’t have?

Never

0

Almost Never

1

Seldom

2

Half Time

3

Usually

4

Almost Always

5

9-10

Interviews

An interview that describes the problem behavior and identifies physical and environmental factors that reliably result in the problem behavior.

Advantages DisadvantagesProvides information of potential function

Assessment is time consuming

Provides information of possible setting events

Information may or may not be reliable

Provides information regarding resources for developing a positive behavior support plan

11-13

Interview Information What exactly does the behavior look like? What do you think is the function of the behavior? What events/situations predict the behavior? What are the learning characteristics? What does the child like or not like? How does the child communicate needs, wants, etc.? What are some of the other factors (e.g., medical,

schedule) that may influence behavior?

11-13

Scatterplot An interval recording system that assists in

determining if patterns of problem behavior exist during specific time periods

Advantages DisadvantagesPinpoints the time periods in which the behavior is likely and unlikely to occur.

Little information on setting events, environmental influences, or antecedents and consequences

Quick to complete and interpret

No information on prior interventions

Assist in identifying functions

14-16

Scatterplot Form

Time/Activity8:00 - 8:20

8:20 - 8:35

8:35 - 9:15

9:20 - 9:35

9:35 - 9:559:55 - 10:30

1 2 - 3 > 3

9/12 9/13 9/14

0

14-16

Scatterplot Form Case Study

Time/Activity8:00 - 8:15

8:15 - 8:30

8:30 – 8:45

8:45-9:00

9:00 - 9:159:15 - 9:30

6-10 11-15 > 15

9/12 9/13 9/14

<5

14-16

Scatterplot Form Activity

Time/Activity

14-16

Scatterplot Form

Time/Activity8:00 – 8:30

8:30 – 9:00

9:00 - 9:30

9:30 – 10:00

10:00-10:3010:30 - 11:00

1 2 - 3 > 3

7/28 7/29

0

14-16

ABC Analysis

Event recording system that determines patterns of antecedents and consequences associated with a particular behavior.

Advantages DisadvantagesDescribes antecedents and consequences to the behavior.

Does not provide information on the times antecedents and consequences were prevalent and no behavior occurred.

Provides confirmation of the hypothesized function of the indirect assessment.

Can be time consuming.

17-22

Antecedent-Behavior-Consequence Analysis

Date Antecedent Behavior Consequence

17-22

What do I do with all of this? (i.e., How do I summarize the data?) Evaluate the antecedent that are predicting the behavior

Antecedent Behavior Consequence A T E ?

Task demand (put away)

Verbal outburst, throws object

Removed to principal’s office

x

Task demand (make correction)

Verbal outburst No redirection x

Task demand (put a way)

Verbal outburst, Attempts to leave


x

Task demand (give a turn)


17-22

What do I do with all of this? (i.e., How do I summarize the data?) Evaluate the consequences that are maintaining the behavior





x






x



17-22

What do I do with all of this? (i.e., How do I summarize the data?) Evaluate the whole sequence





x






x x



17-22

What do I do with all of this? (i.e., How do I summarize the data?) Evaluate the antecedent that are predicting the behavior





x

Playing alone Throws objects T. asked why and removed to TO

x

Asked to leave computer and move to table

Argues Given 3more minutes

x

Task demand Hits Redirected to the task

x

2

17-22

What do I do with all of this? (i.e., How do I summarize the data?) Evaluate the consequences that are maintaining the behavior





x


x



x


x

2

17-22

What do I do with all of this? (i.e., How do I summarize the data?) Evaluate the whole sequence





x


x



x


x

2

17-22

ABC Analysis Case Study

36


Task demand (write name)

Bangs head with hands

Attention: “Don’t hurt yourself”

X X

Alone in play area

Bangs head on bookshelf

Ignore X

Toy out of reach Bites wrist Is given toy X

Transition from free time to academic time

Bangs head with hands and toys, screams

Guided to academic area

X X

Summarize Eric’s Data

Evaluate the whole sequence Antecedent Behavior Consequence A T E ?

No attention: Teacher with another student

Disruptive (humming)

No attention: Teaching walking around classroom

Disruptive (sighing, tapping pencil)

No attention: Teacher at the

board

Disruptive (tapping table)

Teacher tells him to work quietly

Teacher walks to Eric & helps him

Teacher talks to Eric & Eric goes to the bathroom

X

X

X X

17-22

Environmental Manipulation Systematic manipulation of environmental variables

that you believe will and will not result in the demonstration of the problem behavior.

Can only be used when it is possible for the interventions to manipulate the relevant factors (hot vs. cold, tired vs. awake)

Potential benefits of the procedures should be weighed against the potential risks to the student

Required consent Strategies should be developed to ensure safety of the

student, the interventionist, and others in the environment

This is just an overview.

23-25

Environmental Manipulations

Advantages Disadvantages

Validates hypotheses regarding the functions of the behavior.

Implementation of environmental manipulations may provoke problem behavior. (Ethical considerations)

Assists in identifying the multiple functions of a behavior.

Time Consuming

Initial manipulations may fail to verify the hypothesized function of behavior.

23-25

Environmental ManipulationsAntecedent – variables are set up in advance and are not

contingent on problem behavior (e.g., student is given hard task versus an easy task; low attention versus high attention)

1. Based on the ABC, identify the variables that are likely to influence problem behavior.

2. Identify a time period and situation that can be set up to test your hypothesis (e.g., high rates of attention and low rates of attention).

3. Collect data on the problem behavior that occurs in each condition

4. Conduct the conditions across several days, testing each condition at least two times.

23-25

Antecedent Manipulation Case Study

Hypothesis: Given an academic demand, Nick will bang his head to avoid doing the work.

FA could help determine if the subject of the task influenced the rate of head banging.

23-25

Case Study1. Develop a hypothesis about two variables that you believe to

influence challenging behavior2. In the same setting, test out those two variables related to their

effects on the student’s behavior

23-25

Environmental ManipulationsConsequence – variables to be tested are presented contingent on

problem behavior exhibited by the student.1. Based on the ABC, identify the variables likely to influence

problem behavior.

2. Identify a time period and conditions that can be set up to test your hypothesis.

3. Based on problem behavior, variables are implemented. For example:

• During an escape condition, when the problem behavior occurs, the task is removed

• During an attention condition, when the problem behavior occurs, attention is provided

• During a tangible condition, when the problem behavior occurs, a tangible item is provided 23-25

Developing a Hypothesis Statement Hypothesis statements are developed for

each behavior. Review the data to identify patterns:1. Under what condition does the behavior

occur?2. What happens when the behavior occurs?3. Summarize when X happens, S engages in

problem behavior to get Y

26-27

Hypothesis Development

when this happens (setting event /context/antecedent)

the student does (describe the target behavior)

for what purpose (obtain/escape/avoid)

When William has to wait for the bus and he is presented with a difficult task

screams, swings his arms

to escape having to do the work

When Annie has been working independently on a math assignment

Wanders the classroom shoving the materials of her classmates on the floor

to obtain attention

After a weekend with his grandparents and when transitioning from recess to reading groups

Quintalis puts his head down and begins to doodle on the paper

to escape having to read

26-27

Case Study

Given a math assignment, Nick will bang his head to escape his math work.

46

Developing a hypothesis statement Using your example student, develop a

hypothesis statement for each behavior.

26-27

Hypothesis Statements Student: when this happens (setting event /context/antecedent)

the student does (describe the target behavior)

for what purpose (obtain/escape/avoid)

26-27

Questions?