Heather Peshak George, Ph.D.

Heather Peshak George, Ph.D.
Session 12 & 17 Complex Functional Behavioral Assessment/ Behavior Intervention Planning Heather Peshak George, Ph.D. University of South Florida – Tampa Bay August 17-18, 2010 WI PBIS Network: Coaches Training – Stevens Point, WI

Agenda Overview of Behavior Principles Data Basics
Functional Behavior Assessment Data Basics Levels of Positive Behavior Support ERASE (Liaupsin, Scott, & Nelson) Prevent-Teach-Reinforce (PTR)

Objectives Participants will:
Describe behavioral principles underlying functional assessment of problem behavior Identify measures for baseline data gathering and progress monitoring Compare and contrast secondary and tertiary behavior support models Identify key factors that impact intervention effectiveness Apply an individualized PBS model

What Would You Do If…? Paul: Shouts profanities and throws things
Kevin: Refuses to respond and turns away from the teacher Jenny: Stomps out of class without permission

Traditional Approaches to Dealing With Difficult Behavior
Punishment Exclusion Counseling

The Problem The child IS the problem so fix him/her
Punish the child to teach a lesson We hope the problem will go away…Does it? Who benefits the most from this approach? The child HAS a problem so fix it Change the environment Teach new skills Problem less likely to occur

Comparison of Traditional Behavior Intervention Plans and Positive Behavior Intervention Plans
Traditional BIP: Focuses on the student needing to be changed Eliminating undesirable behavior is the goal Uses mostly reactive strategies (consequence-based) Usually includes punitive interventions Positive BIP: Focuses on the context/environment Goal is to replace problem behavior with a functionally equivalent behavior or skill Uses multi-component interventions Preventative Replacement behavior Responding/Reinforcement

Given 60 seconds, use 4 straight lines to connect all of the dots without lifting your pen

A box to think outside of:
Child

There are many other boxes to explore
Child There are many other boxes to explore

Principles of Behavior

Behavior Anything we say or do
Much easier to change things we can observe Think about whether you can see or hear it What about thoughts? Intentions? Best not to focus on these as becomes more of a guessing game

How are Behaviors Learned?
Stimulus/Antecedent (Sd) Behavior Consequences/ Reinforcement

Increasing Behaviors 2 Categories of Reinforcement Positive Negative
Addition of pleasant stimulus after behavior Example: getting a popsicle when you say “popsicle” School examples: verbal praise, earning points, stickers , stars, access to preferred activities….. Negative Removal of unpleasant stimulus when target (desired) behavior occurs Examples: Seat-belt buzzer, erasing name from the board, completing work to keep from sitting out of recess, allowing escape from work contingent upon completion of tasks…. Reinforced behavior will be repeated. Involves presenting appropriate consequence following desired behavior. If increases observed, reinforcement has been inferred. Negative example: removing additional school assignment contingent on youth’s successful participation in social interaction Conditions for reinforcement to occur: 1. Positive consequences provided contingent on occurrence of desired response. 2. Should be temporally connected to desired responses (immediately following desired behavior). If delays occur, student may not know why they are being reinforced—or other behaviors occur and may be inadvertently reinforced Avoid satiation—don’t provide reinforcers in excessive quantities or insufficient varieties.

Decreasing Behaviors Punisher
Addition of an unpleasant stimulus after behavior that decreases the likelihood that behavior will be performed in the future If the behavior does not decrease as a result of the response, that response is NOT a punisher!!!! (even if it is an unpleasant stimulus) Example: Suspending a student who does not want to be in class or school—Is suspension a punishment or a reinforcer?

Use of “Punishment” Must ensure fit with the function of behavior
If behavior is to escape, then expulsion, suspension, time-out, or send to principal or behavior specialist does NOT fit (and will not be effective in decreasing the student’s problem behavior) If behavior is to get attention, do not send them to the counselor, social worker, or behavior specialist if s/he is going to talk to or calm them What happens in the main office, the behavior specialists’ or counselors’ office at your school?

Functional Behavior Assessment Process

Function and Context People behave for a reason – this is “function”
Does he/she get something? Tangibles, attention, stimulation, people, etc. Does he/she avoid or escape something? People, activities, embarrassment, tasks, etc. Context Things in the environment (items, persons, actions, events) affect the likelihood of a behavior Facilitator Script: To determine function we ask questions regarding what the student gets or avoids by behaving. Once we know why a student behaves we have the information we need to create an individualized intervention. Tips: Spend some time discussing the issue of function. Ask for examples of how students access or avoid different things in school through appropriate behavior. Ask for examples of how students access or avoid different things in school through problem behavior. Ask for examples of how environmental factors (time of day, persons present, tasks, etc.) affect behavior.

Functional Behavior Assessment
Purpose: Assess behavior in relation to environmental contexts (antecedents and consequences) To identify the function(s) maintaining problem behavior To guide the development of an individualized, data-based behavior support plan

Functional Behavior Assessment
More than just paperwork to meet IDEA More than just a step before a diagnosis or placement change is made An ongoing process, not an event Is a tool to: Change the environment to make behavior less likely Teach the student new skills Set the student up for success

The FBA Process Identify and define problem behavior
Identify patterns of problem (and appropriate) behavior-- antecedent and consequent events Identify the function of behavior—hypothesis Develop an intervention plan Monitor the effectiveness of the intervention

Identify Problem Behavior
The definition needs to be operationalized Observable Measurable Accurate Detailed Can you hear it, see it?

Define Problem Behavior
Non-Examples Tantrum Hyperactive Angry Aggressive Examples Screams, falls to floor, pounds fists on the floor Jumps out of chair w/o permission; shouts responses Throws materials on the floor when asked to do math tasks Punches peers on their body with his fists

Identifying Patterns: Methods To Collect FBA Data

Functional Behavior Assessment/ Gathering Information
Indirect Record Review Interviewing—PTR Assessment Checklists—ERASE/PTR Assessment Direct Scatter plots ABC Data Collection—ABC Card Select best ways to gather information about operationalized behavior

The ABCs of Behavior A = Antecedent B = Behavior C = Consequence

ABC Analysis Antecedent: Behavior: Consequence:
What happens immediately before the behavior? Behavior: The actions of the student Consequence: What happens immediately after the behavior? Facilitator Script: When conducting a functional assessment we often use an “ABC analysis.” The ABC stands for “antecedent” or what happens just before the behavior, “behavior” or the student’s actions, and “consequence” or the things that happen immediately after the behavior. The ABC analysis helps us understand how elements of the student’s environment can predict the student’s behavior. Tips: Provide some simple examples of antecedent, behavior, consequence chains. Ask participants to share examples of these chains from their own lives.

ABC ABC Behavior Antecedent Consequence What a Person Says or Does
Medical & Physiological Environmental Curricular & Instructional Interactional Personal & Control Issues What a Person Says or Does Social/attention Tangible Escape/avoidance Sensory/intrinsic Under what circumstances does behavior occur? What outcomes are produced?

Activity As a group, determine the function of behavior for the next two students Answer using your hands (appropriately):  Right hand up: Escape Left hand up: Attention Both hands up: Sensory Both hands down: I am not paying attention

Activity: ABC Analysis
JOHN LEAVES CLASS WITHOUT PERMISSION – WHY? All things that happen just before behavior All things that happen just after behavior The student’s behavior John fights with his girlfriend before school. The teacher asks him to do an independent writing assignment. John stares at his paper, gets up, kicks the desk, and stomps out of the classroom Teacher tells John to stop and get back to his seat. She writes a referral to the office. John is suspended for 3 days. !This slide contains an Animation! Facilitator Script: Put in examples of high school behaviors (skipping, or brings cigarette lighters to class,)—nonreaders—escaping environment want something fun ABC analysis is most commonly conducted by observing and writing down the antecedents, behaviors, and consequences as they occur. However, an ABC analysis does not necessarily have to be done as you sit in a classroom observing. It can be done in your head as you consider the types of actions, events, and persons, that tend to predict a student’s problems and the types of consequences that are preferable for the student. In this example, Susan calls Brenda a “creep face” and laughs. Brenda punches Susan in the arm. And Susan stops laughing and walks away. If this pattern recurs often, we might describe Brenda’s behavior as purposeful in that it worked to get Susan to go away and stop bothering her. Tips: Describe the purpose of an ABC analysis. Click once to bring up each example under A, B, and C. Click once to display the Possible Function. Discuss how the ABC format leads to some possible hypotheses of function for Brenda. NAME THAT FUNCTION! Possible Function of John’s Leaving Class Behavior: WHEN JOHN IS ASKED TO DO A NON-PREFERRED INDEPENDENT ASSIGNMENT REQIRING WRITING, HE WILL LEAVE CLASS TO AVOID DOING THE WORK. THE BEHAVIOR IS MORE LIKELY TO OCCUR WHEN HE HAS A FIGHT WITH HIS GIRLFRIEND.

Activity: ABC Analysis
BRENDA HITS OTHER STUDENTS - WHY? All things that happen just before behavior The student’s behavior All things that happen just after behavior Susan calls Brenda a “creep face” and laughs at her Brenda punches Susan on the arm Susan stops laughing and walks away !This slide contains an Animation! Facilitator Script: ABC analysis is most commonly conducted by observing and writing down the antecedents, behaviors, and consequences as they occur. However, an ABC analysis does not necessarily have to be done as you sit in a classroom observing. It can be done in your head as you consider the types of actions, events, and persons, that tend to predict a student’s problems and the types of consequences that are preferable for the student. In this example, Susan calls Brenda a “creep face” and laughs. Brenda punches Susan in the arm. And Susan stops laughing and walks away. If this pattern recurs often, we might describe Brenda’s behavior as purposeful in that it worked to get Susan to go away and stop bothering her. Tips: Describe the purpose of an ABC analysis. Click once to bring up each example under A, B, and C. Click once to display the Possible Function. Discuss how the ABC format leads to some possible hypotheses of function for Brenda. NAME THAT FUNCTION! Possible Function of Brenda’s Hitting Behavior: WHEN OTHER STUDENTS CALL HER NAMES AND LAUGH AT HER, BRENDA HITS THEM BECAUSE IT MAKES THEM GO AWAY (ESCAPE)

Antecedents (Before Behavior)
Two types Slow trigger (setting events) Removed in time from the occurrence of behavior Fast trigger (immediate antecedent) Events happen immediately before the problem behavior

Antecedents: Slow Triggers
May happen in or out of the classroom Are conditions that increase the likelihood behavior will occur oversleeping no breakfast forgotten medication conflict with . . .

Antecedents: Fast Triggers
Examples Assignment to easy/difficult Teasing Teacher attending to another student May be consistent Anytime someone asks student to open book May only occur when specific event occurs Only when Ms. Jones asks student to open book

Consequences of Behavior
Responses and/or events occurring after problem behavior What is the pay-off? What does the student get? What does the student avoid?

NAME THAT FUNCTION!

Using Data to Develop a Hypothesis: Your Best Guess

What is a Hypothesis Statement?
A hypothesis statement is: an informed, assessment-based explanation of the target behavior an informed “best” guess about the relation between environmental events or conditions and student’s target behavior

Hypothesis Development
Formula When (trigger/antecedent/setting event) occurs…. the student does (describe behavior)… to (obtain or escape or avoid)…..(function)

Hypothesis Statement: Example
After Chris visits his brother in jail (setting event/slow trigger) and he is asked to complete a task independently (antecedent/fast trigger), Chris shuts his book and puts his head down (behavior) so that the teacher comes over and talks to him and he gets attention (function).

Activity Right hand up: NO! Both hands up: YES!
Are These Hypotheses Complete? Right hand up: NO! Both hands up: YES! Both hands down: I am not paying attention

Are These Hypotheses Complete?
Lisa becomes aggressive when she is angry. Bob acts out to avoid having to go to work in his supported employment program. Joseph exhibits self-injurious behavior because he has autism. Louis brings his cigarette lighter to school to avoid demand situations. Kristy is more likely to draw on the desk when she is required to participate in independent work for extended periods of time in order to gain teacher attention. At least High school examples

Using the Data-Based Hypothesis to Develop a Behavior Intervention Plan

Behavior Intervention Plan
The intervention plan is a plan that: is developed for a specific student addresses specific challenging behavior(s) provides enough detail for anyone to implement The intervention plan is not a general behavior plan a list of suggestions

Selecting Interventions
Select interventions that will make problem behavior: Irrelevant—Antecedent or Prevent Interventions Changes to the environment (the triggers) so that problem behavior is not necessary Inefficient—Replacement Behaviors or Teach New behavior is easier and results in a faster outcome than the problem behavior Ineffective—Responding to Behavior or Reinforce Responding so that new behavior has the same outcome as problem behavior but greater than problem behavior

Replacement Behaviors
Replacement behaviors are what we want the student to do instead of the problem behavior Effective replacement behavior must: Be incompatible with the problem behavior Serve the same function as the problem Problem Behavior Facilitator Script: The first step in the intervention planning process is to determine what it is that the student should be doing instead of or in place of the problem behavior. To simply attempt to squash a problem behavior without providing a replacement will not be an effective intervention in the long run. A replacement behavior is both incompatible with the identified problem behavior – that is, the student cannot do both at the same time – and serves the same function as the problem. When both these conditions are met, replacement behaviors are much more likely to work. However, you’re probably thinking that many students already have the skills to perform replacement behavior but simply choose not to use them – and in other cases they don’t have the skills to perform the replacement behavior. These circumstances call for different approaches and we’ll discuss how interventions involve much more than simply telling students what we want them to do. Tips: Consider providing examples of how punishing the problem behavior without providing a replacement behavior will not be productive. FUNCTION REPLACEMENT Behavior

Two Types of Replacement Behaviors
Functionally equivalent More appropriate way to get the same outcome Not the expected or desired behavior Intermediary behavior that will be faded Asking for a break, brain break pass, secret signal for attention, work check pass, tardy pass, requesting cool off or calming strategy Desired, prosocial Behavior expected of the student to get the same or different outcome Raising hand, asking for item, completing assignment, coming to class on time, transitioning

Activity: Identify Replacement Behaviors
For each behavior listed in the table: Identify one functionally equivalent, intermediary behavior Identify one desired, expected behavior

Identify Replacement Behaviors
Problem Behavior Function Replacement Behavior Refusing to transition to next activity in class Delaying/avoiding transition Refusing to answer in front of peers Escape peer attention or embarrassment Leaving class without permission Escape boring (repetitive) tasks Shouting cuss words at adults and peers Get peer’s attention and respect for being a “bad a_ _” !This slide contains an Animation! Facilitator Script: Now here’s a chance for you to practice developing some replacement behaviors. For each of the problems and identified functions, think of a behavior that would be functional and also be relevant, effective, and efficient. You won’t know exactly what is relevant because you don’t know the environment -- but you can guess. Remember that replacement behaviors should be functional and incompatible with the problem behavior. They should also be more relevant, effective, and efficient than the problem behavior. Tips: Discuss each of the four examples with participants. Click once for each example to see the replacement behavior. Remind participants that there may be more than one appropriate replacement for any problem behavior.

Problem Behavior Function Replacement Behavior Refusing to transition to next activity in class Delay/avoid transition R: Request short delay of transition r: Transition to next activity Refusing to answer in front of peers Escape peer attention or embarrassment Leaving class without permission Escape boring (repetitive) tasks Shouting cuss words at adults and peers Get peer’s attention and respect for being a “bad a_ _” !This slide contains an Animation! Facilitator Script: Now here’s a chance for you to practice developing some replacement behaviors. For each of the problems and identified functions, think of a behavior that would be functional and also be relevant, effective, and efficient. You won’t know exactly what is relevant because you don’t know the environment -- but you can guess. Remember that replacement behaviors should be functional and incompatible with the problem behavior. They should also be more relevant, effective, and efficient than the problem behavior. Tips: Discuss each of the four examples with participants. Click once for each example to see the replacement behavior. Remind participants that there may be more than one appropriate replacement for any problem behavior.

Problem Behavior Function Replacement Behavior Refusing to transition to next activity in class Delaying/avoiding transition Refusing to answer in front of peers Escape peer attention or embarrassment R: Cue/pass to not answer R: Answer question Leaving class without permission Escape boring (repetitive) tasks Shouting cuss words at adults and peers Get peer’s attention and respect for being a “bad a_ _” !This slide contains an Animation! Facilitator Script: Now here’s a chance for you to practice developing some replacement behaviors. For each of the problems and identified functions, think of a behavior that would be functional and also be relevant, effective, and efficient. You won’t know exactly what is relevant because you don’t know the environment -- but you can guess. Remember that replacement behaviors should be functional and incompatible with the problem behavior. They should also be more relevant, effective, and efficient than the problem behavior. Tips: Discuss each of the four examples with participants. Click once for each example to see the replacement behavior. Remind participants that there may be more than one appropriate replacement for any problem behavior.

Problem Behavior Function Replacement Behavior Refusing to transition to next activity in class Delaying/avoiding transition Refusing to answer in front of peers Escape peer attention or embarrassment Leaving class without permission Escape boring (repetitive) tasks R: Request break r: Stay in class and work on task Shouting cuss words at adults and peers Get peer’s attention and respect for being a “bad a_ _” !This slide contains an Animation! Facilitator Script: Now here’s a chance for you to practice developing some replacement behaviors. For each of the problems and identified functions, think of a behavior that would be functional and also be relevant, effective, and efficient. You won’t know exactly what is relevant because you don’t know the environment -- but you can guess. Remember that replacement behaviors should be functional and incompatible with the problem behavior. They should also be more relevant, effective, and efficient than the problem behavior. Tips: Discuss each of the four examples with participants. Click once for each example to see the replacement behavior. Remind participants that there may be more than one appropriate replacement for any problem behavior.

Problem Behavior Function Replacement Behavior Refusing to transition to next activity in class Delaying/avoiding transition Refusing to answer in front of peers Escape peer attention or embarrassment Leaving class without permission Escape boring (repetitive) tasks Shouting cuss words at adults and peers Get peer’s attention and respect for being a “bad a_ _” R: Ask for attention r: Get peer’s attention for completing work !This slide contains an Animation! Facilitator Script: Now here’s a chance for you to practice developing some replacement behaviors. For each of the problems and identified functions, think of a behavior that would be functional and also be relevant, effective, and efficient. You won’t know exactly what is relevant because you don’t know the environment -- but you can guess. Remember that replacement behaviors should be functional and incompatible with the problem behavior. They should also be more relevant, effective, and efficient than the problem behavior. Tips: Discuss each of the four examples with participants. Click once for each example to see the replacement behavior. Remind participants that there may be more than one appropriate replacement for any problem behavior.

Use the Pathway! Maintaining Consequence THE FUNCTION Problem
“Get something” “Get away from Something” Problem Behavior Setting Event Triggering Event or Antecedent

BEHAVIOR INTERVENTION PLANNING
Add effective & & remove ineffective reinforcers Neutralize/ eliminate setting events Add relevant & remove irrelevant triggers Teach alternative that is more efficient

“Sam” Kindergarten Aggressive with peers, not participating in activities or following routines, difficulty focusing on any activity ECC program red flagged him due to behavior and lack of academic progress DCFS involved

Summary Statement Function Coupons, Follow routines praise
Desired Alternative Typical Consequence Coupons, praise Follow routines Setting Events Triggering Antecedents Problem Behavior Maintaining Consequences Conflict at home: mornings when not organized for school, not sure who will take Sam to school Does not join activity walks around the classroom, poking and pushing kids morning activity when teacher requests that he sit on chair or carpet for structured activity gives a time out to calm down misses activities Function Replacement Behaviors Walk to a designated area of classroom

Setting Event Manipulations Antecedent Manipulations Behavior Manipulations Consequence Manipulations Re-teach expected behavior for all classroom settings Additional rating periods for expectations Individualized positive greeting by teacher in the morning Walk with “responsible” 4th grade cousin to school. CICO modified (new adult and more specific goals) Teach how to quietly walk to a designated area of the room Teach how to sit and complete tasks for 5minutes up to 10 minutes Points/coupons when participates in activities or quietly goes to his “area” Does not earn points if puts hands on students

Moving from Brief FBA/BIP to Complex FBA/BIP
Team developing plan became more individualized Additional data tool used—Educational Information Tool BIP strategies applied in multiple settings (home and school).

Summary Statement Function Coupons, Follow routines praise
Desired Alternative Typical Consequence Summary Statement Coupons, praise Follow routines Setting Events Triggering Antecedents Problem Behavior Maintaining Consequences Conflict at home: problem behavior at home before school Does not complete work, throws things, laughs, disturbing others Structured academic tasks Teacher walks over, talks to him and helps him get on task Function Replacement Behaviors Ask teacher for help

Setting Event Manipulations Antecedent Manipulations Behavior Manipulations Consequence Manipulations More re-teaching for whole class, how to quietly work Higher rates of praise during activities Use timer so all kids could see how much time they had for activity Cousin involved in CICO process (more encouragement, helping to get DPR home for guardian to see) Guardian uses similar features of CICO at home, teaching, prompting, points Teach how to ask for help Teach how to work in close proximity to peers --sharing supplies and asking for help from peers Points earn extra playtime of choice at end of class Planned ignoring of problem behavior Reward at home when earns DPR points

Self Check for Designing Support Plans
Prevention Strategies Does the plan include changes to the antecedents (triggers) so that problem behavior is not needed? Does the plan include steps to decrease the effects of setting events (distant triggers)? Does the plan include modifications to make desired behaviors more likely?

Teaching Strategies Do the replacement behavior serve the same function as the problem behavior? Is the replacement behavior more efficient and effective than problem behavior? Is there a plan for teaching the skills to the student?

Reinforcement Strategies Does the plan include consequence strategies for (a) strengthening the replacement skills and (b) reducing the payoff for problem behavior (think about the function)? Do consequences for replacement behaviors produce outcomes that are more effective & efficient than the problem behavior? If an intermediary replacement behavior is used, is the reinforcer for the desired/expected behavior greater than and more effective than the reinforcer for the replacement behavior?

Evaluation: Baseline Data Gathering and Progress Monitoring
Look at performance of individual based on manipulation of interventions. Repeated measures (IDEA reauth.) Compare performance under different conditions—comparison of individual, not to others

Baseline Data Must have a method to collect data prior to start of intervention Must track problem behavior Should track appropriate behavior or what you want the student to be doing instead Need a minimum of 5 days of data prior to intervention

Progress Monitoring Continue collecting data daily after intervention implemented Need to use same method of data collection May need to add specific replacement behavior to data collection

Developing Measurement Plan
Identify outcomes most important to the team Keep It Simple--“KIS it” Simple, user-friendly forms to monitor outcomes Rating scales, check sheets Schedule dates for check-ins Use the data!! Evaluate the effectiveness of the support plan at least weekly

Data Collection Methods
Event recording Rate measures Partial/Whole interval Time sampling Latency Duration Task analytic Perceptual AB designs—A = baseline; B = intervention

The Behavior Rating Scale
A rating of the recorder’s perception of the occurrence of behavior Extremely effective in getting data Time efficient Measure of change in behavior Completed as a whole day measure or during specific times of the day Recorder scores on a scale of 1 to 5 that is defined for each behavior

Requesting Attention/
Behavior Rating Scale Behavior Date Hitting 8 or more 6-7 times 4-5 times 2-3 times 0-1 times 5 4 3 2 1 Profanity 16 or more times 12-15 times 8-11 times 4-7 times 0-3 times Requesting Attention/ Assistance 55% or more 40-55% 25-40% 10-25% 0-10%

Data Gathering Measure—Jack (Leaving Class W/O Permission
Week of _____________ Monday Tuesday Wednesday Thursday Friday English Pre-Algebra World History Computer Lab Study Lab Average Score Average Score: 3 2.2 1.4 .8 Change to a middle school/high school example Rate the problem behavior: 0=no problems, 1 = stayed in class and worked on task with one reminder prompt, 2= stood up from desk; sat back down; delayed start of assignment; 3= left class

Ben’s Playtime 3=Cooperated, stayed briefly
2=Fussed, took several turns 1= Cried, refused to play 4=Laughing, stayed Monday Tuesday Wednesday Thursday Friday Saturday 4 3 2 1

Team-Driven Process

Importance of Team-Driven Actions
Greater likelihood of teacher buy-in Greater likelihood of intervention implementation Problem-solving process becomes broader Teacher ownership of “problem” increases Relationship with facilitator and impact on intervention acceptance Must be collaborative Cannot come in and tell teacher what to do

Behavior Support Team A collaborative group of individuals who assess and develop individualized, proactive, continuing supports Information Gathering Hypothesis Development Creation of the Support Plan Implementation of Interventions

Membership on Behavior Support Teams
People who know the focus student well and have a vested interest People who know supports and resources (and methods of accessing them), as well as potential barriers Members to allocate personnel and fiscal resources

A Tiered Approach to Meeting Individual Student Needs

Individualized PBS (Tertiary)
For high-risk students: History of severe problem behaviors Demonstrated resistance to intervention An intensive system of support is needed ~5% ~15% Students who are at the top of the triangle need more intensive, individualized supports. These students are not or have not responded to other supports in your school. Not all students at the top of the triangle will need an individual behavior support plan. Many will benefit from a targeted group intervention. Those who do not, however, need additional support. Many of these students are classified as EH, ED, SED, etc… These are the students with the most frequent and/or most severe problem behavior. ~ 80% of Students

Which Students Need PBIS?
Address Individual level PBIS if: One or more students receive many referrals One or more students exhibits severe or dangerous behavior School-wide screenings and teacher referrals identify students with problem behavior School-wide, classroom, or targeted group interventions have not resulted in improved behavior for one or more students Students in ESE settings with persistent or violent behavior who may not generate office referrals Examine your school’s data to determine what students may need an individualized plan. Certainly, any student who is a danger to his self or others, will likely require an individualized plan. Also, remember those students who are in special education settings that do not get an office discipline referral for their behavior.

Office Discipline Referrals
Every school will have students who fit in this area. If these students are having an impact on the culture of your school or are a danger to themselves or others, you may decide to intervene directly with these students before trying anything else. Or, if these students are still generating referrals at a high rate in spite of other intervention efforts, then individual-level PBS would be appropriate. It’s important to remember that individual-level PBS is the most detailed, intensive kind of support you can provide a student. It takes a lot of time and energy to build a support plan, so be sure that the students who are receiving this service really need it. Student

Why ODRs May Not Be Enough
May miss students in ESE settings with persistent or violent behavior who may not generate office referrals May not identify students with severe “internalizing” behaviors May not identify students with many “minors” but few “majors” May not reflect that some teachers write referrals and others do not

Other Ways to Identify Students
Behavior screenings 1-2 times per year teachers “nominate” and rank students Teachers complete validated rating scale (CBCL-TRS or SSBD) Teacher referrals Identify concern Prioritize within classroom Must have a process to prioritize identified students

Activity: Student Referral Process
What is the process in your school? What form? Where do you submit it? When does support occur? Who is involved? How are student needs prioritized? How is your SWPBS process and team involved? Are you working smarter or harder?

Conceptualizing an Array of PBIS Supports
Universal/Primary School-Wide Assessment School-Wide Prevention Systems Classroom Interventions Targeted/ Secondary Tertiary (Intensive) Group Interventions Analyze Student Data Assessment Interviews, Questionnaires, etc. Simple Student Interventions (ERASE) Intervention Observations and ABC Analysis Complex Individualized Interventions (PTR) Team-Based Wraparound Interventions Multi-Disciplinary Assessment & Analysis Scott, 2001

Principles of Practice
Levels of support range from simple classroom consultation to intensive wrap-around plans All levels include data collection and functional behavior assessment All levels match interventions to functions of behavior and the school’s context Individualized PBS has a focus on being proactive, educative, and research- and data-based. It is more than a typical IEP team meeting. Educators and family members establish lifestyle goals for the student, perform a detailed FBA (home and school settings), and work out a support plan based on the results of the FBA.

How to Make PBIS Work Be pragmatic
Effectively and efficiently match your resources to the complexity of the behavior problem Serious/complex behavior problems = additional resources and approaches Less intensive behavior problems = fewer resources

System Changes to Consider
System for submitting a request for assistance Form, to whom, where, what information is needed? System for prioritizing students Identify who will facilitate teams System for notifying other team members Identify a set a time period until a baseline data meeting Identify a set time period until intervention meeting

Purpose of P-T-R To provide schools with a standardized, easy-to-use model with which to apply research-based, behavioral strategies for addressing the most serious problem behaviors of students. For all students with serious problem behaviors --- special education, general education. Intended for pre-K through high school, however research has just been conducted in grades K-8

PTR Model Research-based Practices Team-driven decision-making
Assessment and Intervention Team-driven decision-making Steps are scripted as much as possible Each step ends with self-evaluation (checklist) Selection of interventions is menu-driven Entire process is manualized

The PTR 5-Step Process Developing a Team
Establishing clear goals (short and long term) Functional Assessment Designing and Implementing a Behavior Intervention Plan Evaluation (ongoing) and Revision (as necessary)

Step 1: Overview Team Building
Team Development Include: Teacher who has the child for the majority of the day; Special educator if the child receives part-time services in special education; Behavior specialist who has expertise in functional assessment and behavior analysis; and Others, such as family members, paraprofessionals, special area teachers. Team function Roles and Responsibilities Behaviors and Commitment

Step 1: Team Building Ensuring a Successful Team
What information does the team need to address to ensure a successful BIP process? Teacher/Therapist Work Style Survey Paraeducator Work Style Survey Classroom Team Survey A collaborative process Teacher and facilitator relationship

Step 1: Team Building Issues to Address
Are there others who need to be a part of the team? Identify the roles and responsibilities of each team member Identify a consensus-making process

Case Study—Step 1: Team Building
Mike is a 9-year-old male in a self-contained autism classroom Nonverbal—uses signs, Dynamite, and pictures to communicate 1 teacher, 2 aides, and 6 students

Case Study—Step 1: Team Building
Teacher-- Ms. Wonderful Aides Ms. Needs Help Ms. Also Needs Help Facilitator—PTR Consultant Results of teaming information indicate a great team that meets regularly to brainstorm

Step 2: Overview Goal Setting
Team engages in a process for identifying problem behavior and possible replacement behaviors to target in 3 areas: Academic Social Behavior Team defines short term goals in operational and measurable terms Team prioritizes short term goals and develops a baseline data collection system

Step 2: Goal Setting Identifying Behavioral Goals
Address school-based events that can be changed within the school year Problem Behaviors & Replacement Behaviors Leaving class without permission Remaining in class throughout the period and/or requesting a break Social Deficits & Social Skills Using profanity when mad at peers & adults Expressing frustrations and needs appropriately Academic Behavior & Pro-Academic Skills Not finishing work/completing work independently Disengaged/Engaged during independent work time

Step 2: Goal Setting Identifying Behavioral Goals
Social Academic Broad The broad skill or outcome the student needs to learn (e.g., communicate wants/needs, initiate peer interactions, task engagement) Decrease What the student is doing now that is keeping him/her from meeting the broad goal Increase The more specific behavior the student should engage in to meet the broad goal

Case Study—Step 2: Goal Setting
Behavior Social Academic Decrease Increase Broad Mike will communicate his wants and needs appropriately Mike will interact with peers appropriately Mike will comply with nonpreferred activities and requests Mike will decrease screaming, hitting, and getting out of his seat Mike will decrease hitting, screaming at, and bossing his peers Mike will decrease screaming and hitting Mike will ask for a break or for attention when needed Mike will initiate peer interactions using his Dynamite Mike will engage in nonpreferred activities and communicate his frustration using his Dynamite or an appropriate tone

Step 2: Identify Baseline Data Collection System
Baseline data gathering Identify no more than 3 problem behaviors of concern and the skills to replace (increase) Operationally define all targeted behaviors Identify how and when data will be collected Need at least 5 days of baseline data

Case Study: Operational Definitions of Problem and Replacement Behaviors
Screaming—loud, high pitched noise heard outside the classroom Hitting—anytime Mike touches peers or adults with an open hand, fist, foot, or object while screaming or protesting Expressing Frustration—using Dynamite, pictures, or signs to ask for a break or attention Transition to nonpreferred activities—moving to nonpreferred activity and engaging with appropriate verbal expression (screaming level)

Case Study: Behavior Rating Scale With Anchors
Date Screaming 9+ times 7-8 times 5-6 times 3-4 times 0-2 times 5 4 3 2 1 Hitting 8+ times 6-7 times 4-5 times 2-3 times 0-1 times Expressing Frustration 40%+ 30-40% 20-30% 10-20% 0-10% Transition to Nonpreferred Whimper or squeal Louder than indoor voice Outdoor play voice Louder than outdoor play Ear penetrating

Using the Behavior Rating Scale (BRS)
Perceptual rating Behavior recorded at least once daily May be specific to a setting, activity, time of day May be whole day May be combination of both Use anchors on a scale of 1-5

Determining the Anchors on the BRS
Behavior can be measured using Frequency (times per day) Duration (hours, minutes, seconds) Intensity (how hard, how loud, bruise, etc.) Percent of day Percent of occurrence Percent of opportunity

Questions to Guide the BRS
What is the behavior like on a typical day? What is the goal you would like to reach within the next 3 months, school year, etc? What is more important to you: how loud it is or how long? how hard it is or how often? Is the number of times the skill can be used the same each day?

Step 3: Overview PTR Assessment (FBA)
Each team member independently answers a series of questions related to: Observed antecedents/triggers of problem behaviors Functions of the problem behaviors Consequences ordinarily associated with the problem behaviors Synthesized input leads logically to development of three intervention components (prevent, teach, reinforce)

Step 3: PTR Assessment The Assessment Summary Table
All responders’ answers reflected on summary table Group/organize responses into similar categories Prevent Specific subjects, information about curriculum Transitions (within and to/from classroom) Unstructured times (e.g., centers, recess, free play) Setting events/slow triggers (e.g., temperature, meds, sleep, illness) Teach—Functions Attention seeking Escape Access to items/people Reinforce Consequences resulting in attention, access, and/or avoidance Identify questions that need answers

Case Study—Step 3: PTR Assessment Problem Behavior
Prevention Data Teach Data Reinforce Data Non-preferred task Reading, Math Transition Preferred to non-preferred Change in schedule Denied item, told no, or to fix something Other students upset/mad Teacher attending to others Gain attention Peers, adults Delay Access to items Redirected Reprimanded Calm/soothe Personal space Later must complete task Loses/delays reinforcers Screaming, Hitting

Case Study—Step 3: PTR Assessment Appropriate Behavior
Prevention Data Teach Data Reinforce Data Independent work One-on-one attention Specials Peer interaction Getting attention Raising hand Sharing attention Conversation skills Taking turns Waiting Self-management Asking for break Expressing emotions Treasure box Movie Attention Helping teacher Going to media center Going outside Walk Food Prosocial

Step 3: PTR Assessment—Developing the Hypothesis
When…. Student will…. As a result… Inappropriate Behavior Appropriate Behavior Prevention data = antecedents or triggers Teach data = replacement behavior and possible function Reinforce data = function and reinforcers

Case Study—Step 3: PTR Assessment Possible Hypotheses
When…. Student will…. As a result… Mike is asked to complete non-preferred task (Reading, Math), stop preferred activity or transition to nonpreferred activity, fix an error, or when teacher attending to other students scream and hit Mike is able to gain attention and delay the transition/activity Mike is asked to complete non-preferred task (Reading, Math), stop preferred activity or transition to non-preferred activity, fix an error, or when teacher attending to other students express his frustrations appropriately complete the assigned task Mike is able to delay the transition/activity Mike is able to gain attention Inappropriate Appropriate

Step 4: Overview of PTR Intervention
Team identifies appropriate interventions for each component (prevent-teach-reinforce) from a menu of options Behavior intervention plan developed Consultant provides training and on-site assistance for final interventions agreed upon Fidelity of implementation is tracked

Step 4: PTR Interventions List of Activities to Address
Review Intervention Checklist Discuss interventions selected Do they match the function? Can they be done in the classroom? Do they match the context of the classroom? Describe how interventions will look in teacher’s classroom (develop the BIP) Discuss training Discuss in-class coaching/technical assistance Discuss fidelity

Step 4: PTR Intervention Using the Intervention Checklist
Record each team member’s rank on the checklist Develop a list of preferred interventions Mean of ratings Interventions rank ordered #1 Number of people selecting specific intervention *Be sure to make note of interventions ranked highest/selected by teacher

Step 4: PTR Intervention Developing the Intervention Plan
Guide the team to identify interventions Use Intervention Checklist Provide examples Ask them questions How might this strategy look for student? Are you going to always be available? Is this doable? Ensure fit with the classroom Ensure fit with the function

Case Study: Tips on Linking Interventions to Hypothesis
Prevention strategies must address: Getting Mike attention more often Changing non-preferred task Particular student How it is done (format) Changing what happens when he makes a mistake Do part of it (rather than all of it) over Allow him to find what is wrong Provide social story Signaling end of preferred activity Teach strategies must address: How to get attention/assistance How to get break/delay appropriately Reinforce strategies must address: Giving Mike attention/help Giving Mike break/delay

Step 4: PTR Intervention Writing the Intervention Plan
Task analyze each step of the plan NOT— “give student choices” YES— “at start of reading, tell student ‘we have 2 worksheets today (show worksheets). Which worksheet would you like to do first?’” If teachers do not know how to do it, they will not implement the strategy Make it easy for teachers to do!!

Case Study—Step 4: PTR Intervention
Prevent Strategies Specific Strategy steps Environmental Support A wait card will be placed on Mike’s desk to assist him in remembering to wait his turn. 1. Prior to group work, tell Mike, “Remember, when it is someone else’s turn, you sit quietly and wait,” while pointing to his card. 2. If Mike calls out, point to his visual to remind him what to do. 3. Use a verbal prompt if the point prompt does not work. Mike’s visual schedule will be modified to detail the number of and type of activities he is to complete during non-preferred activities. For example, if math involves listening to a lesson, doing a hands-on activity, and completing a worksheet, his visual schedule will list each activity under math using either a picture of the type of activity or using numbers that correspond to a number on the worksheet. 1. Prior to the start of the activity, Mike should review the visual schedule. 2. As Mike completes an activity, he should X off the activity.

Specific Strategy steps
Prevent Strategies Specific Strategy steps Curricular Modification Mike will be given an easy, independent activity, such as a worksheet, to complete upon transitioning to a non-preferred activity or an activity that requires him to wait, such as group activities

Specific Strategy Steps
Teach Strategies Specific Strategy Steps Replacement Behavior Mike will be taught to use his Dynamite to express his need to calm down. 1. Mike’s device will be programmed to say “I need to calm down.” 2. Prior to transitioning to a non-preferred activity or at the end of a preferred activity, remind Mike that “if you start to get mad, you can choose to calm down.” 3. As soon as Mike starts to get upset, prompt him to use his device. 4. Once Mike communicates “I need to calm down”, present him with the choice board of calming strategies and ask him, “What do you want?” 5. As soon as he is calm, praise him. 6. Allow Mike to engage in his choice until he is calm for 1-minute. 7. If Mike does not return to his area, then start having a fun time in that area with those students present

Teach Strategies Specific Strategy Steps Self-Management Mike will be taught to independently use his calming strategies. 1. A tracking sheet with smiley faces and sad faces will be given to Mike at the start of each day. 2. Role-play with Mike about when he needs to make the choice to calm down. 3. Practice completing the tracking sheet. 4. Set and review the daily goal for using the calming strategies. 5. Prompt Mike to complete the tracking sheet if needed

Reinforce Strategies Specific Strategy Steps Replacement Behavior Anytime Mike “says” “I need to calm down”, his choice board should be given. 1. Praise Mike for communicating (“thank you for telling me.”) 2. Provide his choice board. 3. Allow him to calm for 1 minute 4. Praise him as soon as he is quiet 5. Praise him for returning to the group Self-Management Anytime Mike scores his behavior, attention should be given. 1. When Mike marks his tracking sheet, praise him for doing so. 2. At the end of the day, review the sheet with Mike. 3. Talk about the sad faces. 4. Provide his reward if his goal is met. Waiting Mike will earn a skittle paired with attention if he waits. This will be faded to an intermittent schedule.

Reinforce Strategies Specific Strategy Steps Transition Mike will earn stars during Reading Centers if he transitions and completes his work without screaming. 1. A social story will be reviewed prior to Reading Centers to remind Mike that he can earn a star if he comes to centers and works. 2. At the end of each reading center, an adult will review Mike’s behavior with him and ask him if he earned his stars. 3. Provide his stars if earned. 4. During the teacher’s group, Mike can earn 2 stars: 1 for transitioning to the group and 1 for working during group. 5. Allow Mike to participate in his chosen activity if he earned his stars.

Step 4: PTR Intervention Teacher Training on BIP
Provide training to practice the plan without student Ask the team questions to ensure understanding Have team role-play steps Obtain 80% accuracy on each step prior to teacher implementing plan with student Coaching Checklist is task analysis of plan

Case Study: Training

Step 4: PTR Intervention In-Class Coaching
Provide X hours in the classroom Model the plan Work with other students Provide feedback Suggest modifications as needed Quality of time rather than quantity

Step 4: PTR Intervention Fidelity
Must measure teacher implementation Adherence—did they do it? What is the most important part of intervention to be implemented to ensure effect? Quality—did they do it correctly? What are all the parts that need to be implemented to obtain optimum effect?

Step 4: PTR Intervention Fidelity Example: Staying in Class
Task analysis of steps of intervention to make leaving class without permission irrelevant Prevent intervention—Curricular Modification Hypothesized function—escape Antecedents identified—Difficult tasks, boring & repetitive tasks, independent seat-work (pencil/paper) Modify assignment so that it is (a) motivating—embeds student preferences; (b) at appropriate difficult level; (c) has meaningful outcomes Present modified assignment to student (and others in class if appropriate) Review assignment, provide examples of completed work Remind student of reinforcement for completing assignment

Step 4: PTR Intervention Fidelity Example: Staying in Class
Adherence--What is the minimal step the teacher needs to do? Prepare and present modified assignment to student Quality--What are all of the steps the teacher needs to do? Ensure modification embeds preferences, is at appropriate difficulty level Reviews assignment and reinforcement

Case Study: Fidelity

Step 5: Evaluation Is it working? Daily ratings of behavior Continuous progress monitoring BRS Other data collection forms Is it being implemented consistently and accurately? Fidelity ratings Is more data needed? Does the plan need to be modified or expanded?

Step 5: Evaluation Case Study: Data

Step 5: Evaluation 1 is a lot of screaming, 5 is no screaming

Step 5: Evaluation 1 is a lot of hitting, 5 is no hitting

Step 5: Evaluation 1 is a little appropriate expression, 5 is a lot of appropriate expression

Step 5: Evaluation 1 is inappropriate transition, 5 is super appropriate transition

Review PTR Process Five-step team-based process
Meetings last minutes Training of teacher in BIP In-class coaching provided Intervention process averages 3 months

Review of PTR Process: Adapt Process as Needed
Combine steps Steps 1 and 2 (teaming and goal setting) Smaller team or team with no history of problems Steps 2 and 3 (goal setting and assessment) Complete step 2 and 3 activities prior to meeting Complete step 3 activity (PTR assessment) during the meeting Steps 3 and 4(assessment and intervention) Complete assessment in meeting and go right into intervention development

Administrative Responsibilities: Tier 3
Identify Tier 3 resources and training as needed Ensure infrastructure in place w/quality reviews Collaborative consultation (MDT & knowledge) Identification and prioritizing of students in need Data system w/meaningful data & data-based decision-making time Time for planning, implementation & progress monitoring Willingness to try “out of the box”, evidence-based interventions Recognize the “workhorses” on your team

Final Thoughts: System Changes
Process may require more time up front but less time overall Teams more likely to implement the plan Ownership Fits the class and the student Continued contact

Absolute Essentials of PTR
A functional team Collaborative, respectful, committed PTR assessment conducted with precision – the more precise and the more confident the team is with assessment results, the more effective the intervention will be 3 components in intervention (at least) – linked to assessment, implemented with fidelity Sensible data collection, and periodic review, revision, celebration, etc.

Potential Reasons Need additional help to address behavior
Identification of function Direct observation of behavior Consistency of intervention Not a complete team Additional interventions – not a complete plan Complexity of behavior Need for Wraparound Model or other additional supports

Questions?

Resources FLPBS:RtI:B Project OSEP TA Center on PBIS
Phone: (813) Fax: (813) Website: OSEP TA Center on PBIS Website: Association on PBS Website:

Heather Peshak George, Ph.D.

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