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Positive Behavior Support (PBS) Training Modules

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1 Individual PBS Module 4: Developing, Implementing, and Evaluating Positive Behavior Support Plans

2 Positive Behavior Support (PBS) Training Modules
This is the third of four PBS training modules. 4. Developing, Implementing, and Evaluating Positive Behavior Support Plans The other modules should be taken in the following order: 1. Collaborative Teaming and Person-Centered Planning 2. Functional Behavior Assessment 3. Instructional Issues and Strategies These modules are designed to support a team as they go through a Positive Behavior Support process with a child or adult with problem behaviors. Let's begin with the first module by reviewing the goal of Florida's PBS Project and the definition of Positive Behavior Support.

3 Hypothesis Development

4 Hypothesis Development Review
In the previous module, you learned about how to use all of the information you have gathered about the focus child or adult to develop one or more hypotheses about why his or her problem behavior is occurring. If you recall, the hypotheses you developed for your focus person should have followed this formula:  When (describe fast trigger and/or slow trigger) occurs The individual does (describe behavior) To get or escape or avoid...(describe functions) Now let’s take a look at Britney’s sample hypothesis statements.

5 Britney's Hypothesis Statements
When Britney goes to sleep after 11 p.m. or does not feel well, she is not engaged during difficult activities (e.g., math, fine motor). She lays on the ground or walks around the classroom, says “no”, and ignores teacher requests to get back on task. She does this to get one-on-one adult attention or to get assistance with the academic task. When Britney is given a direct instruction or is reprimanded in a harsh tone and has been redirected to the task several times she will hit the assistant to get attention and avoid starting the task.

6 Linking Hypothesis to Support Plans
The development of the hypotheses for Britney did not end the PBS process, it began the process of developing more effective interventions for her. In particular, the hypotheses allowed her team to develop appropriate replacement skills that address the functions of the problem behaviors. In other words, now that her team knew what she wanted from her problem behavior, they were better able to teach her more appropriate ways to get attention and support or to avoid a challenging situation.

7 Evaluating Hypothesis
Look again at the hypotheses your team developed. Ask yourself the following questions: Do your hypotheses include: Antecedents (what happens before the behavior) of concern and      Consequences (what happens after the behavior)? Do your hypotheses identify at least one function for the problem behaviors identified? Do the hypotheses statements match the information you have gathered from direct and indirect observations? Do you have all information you need to feel confident that the hypotheses are accurate? Answer Yes or No and move onto the next page

8 Evaluating Hypothesis
Yes: If you have answered "yes" to the above questions, you should feel comfortable moving on the next step of the PBS process: developing, implementing, and evaluating positive behavior support plans  No: If you answered "no" to any of the above questions you might need to meet with your team again before you begin to plan intervention strategies with your team. You should still complete this module, but you will want to make certain that the hypotheses are complete before you start to develop a plan.

9 Areas of Interventions
There are basically four different areas where your team can identify effective strategies for addressing the problem behavior of the focus person. These include: Preventing behavior from occurring Altering the environment Teaching other behaviors Replacement skills General skills Coping and tolerance skills Responding to behaviors Changing consequences for problem behavior Lifestyle enhancements As you can see, the first three areas correspond to the three areas of the hypothesis: antecedents, behaviors, and consequences/functions. The final area, lifestyle enhancements uses some of the critical information you might have identified in the Person-Centered Planning meetings such as the person’s desire to have friends, to be involved in general education settings, or to join a social club. You are now ready to learn different strategies that address each of these three areas and that may be added to your developing support plan. Let’s get started identifying strategies that might be included in your support plan!

10 Preventative Strategies

11 Developing Interventions
You are ready to begin the first intervention: “Preventing Behavior from Occurring.” Preventing Behavior from Occurring: Altering the environment Teaching Other Behaviors: Replacement skills General skills Coping and tolerance skills Responding to Behaviors: Changing consequences for problem behavior Lifestyle Enhancements

12 Preventative Strategies
The first set of strategies in the development of a behavior support plan is intended to prevent the problem behavior from occurring. These strategies include attempts to change the antecedents (fast and slow triggers) that precede the individual's problem behavior. Before we go any further, lets take a moment to review the concept of "fast and slow triggers." This is the first step in identifying what is "setting off" the behavior prior to identifying ways to alter the environment. Antecedents or fast triggers are events that happen prior to problem behavior. These events typically happen immediately before the behavior occurs and sometimes they can be simply to identify. 

13 Preventative Strategies
Some examples of fast triggers are:  Non-preferred activity Demands Working with peers Working alone Teacher attending to another student Slow triggers are sometimes more challenging to identify because they can be removed in time from the occurrence of behavior. Some examples of slow triggers are:    Oversleeping No breakfast Forgotten medication Conflict with another student on the bus

14 Characteristics of Preventative Strategies
Now let's continue discussing preventative strategies. These strategies are intended to change aspects of the environment that address the who, what, when and where of behaviors. For instance, preventative strategies will sometimes attempt to change the conditions that cause problem behaviors to occur by addressing issues around "who" is in the environment. You may want to consider some of the following ideas in your behavior support plan: 1. If you find that certain individuals in the environment make the problem behaviors worse or better, it may be important to consider decreasing or increasing the presence of those individuals. For instance, if Joe always hits Robin when they are paired in team activities, it might be a good idea to consider not pairing them to prevent the problem behavior from occurring.

15 Characteristics of Preventative Strategies
2. You may also find that the total number or type of people in the environment may also impact problem behavior. Some people prefer to have a lot of attention. Others prefer to avoid attention and large crowds. Some people's behavior worsens in situations when they are surrounded by other people with problem behavior. Sometimes a person’s problem behaviors are reduced when they have an opportunity to observe and learn appropriate behavior from typical peers. Changing access to individual adults or students or to an entire group of individuals may be an important preventative strategy to initially deal with problem behaviors. For example, some students work better with the teacher verses the class paraprofessional. Often, teachers usually have to deal with the students who have problem behaviors. Altering the amount of time each adult works with that particular student may be helpful.

16 Altering the Environment: What
Sometimes the content or context of the environment is impacting the person's behavior. Preventative strategies that attempt to change what is happening in the environment are often effective at changing the person's behavior, too. Some of the following strategies are often found to be effective: Provide functional instructional activities:  Activities that are meaningful and produce outcomes that are important to the student/person often result in fewer behavior problems than uninteresting or undesirable activities. Pay attention to the level of difficulty: more difficult activities may result in problem behavior. Additional support or alternating hard and easy tasks has been found to be effective in decreasing problem behavior.

17 Altering the Environment: What
Provide more choices: providing the person with more choices about activities, consequences, social relationships, etc. is an effective strategy that can be applied in all environments. Behavioral momentum: this may sound like a complex idea, but it is really not. The concept is very simple: If you can get a person to start behaving appropriately, they are more likely to continue behaving appropriately. For example, if a child always refused to go to the toilet, but never refuses to go to snack time, you might want to make certain that the toilet entrance is on the way to snack time. The child may be more likely to go to the toilet if he is already motivated to go to a preferred activity.

18 Dividing Responsibility
This strategy allows you to divide teaching time and responsibilities between the teacher and the paraprofessional. For example, rather than the teacher providing all of the one-on-one instruction time with the student, have the paraprofessional work with him or her during a specific task. Structured and concrete activities: provide the student with structured activities and concrete activities with which that they are familiar and successful. Providing students with predictable routines will allow them to understand what is expected from them. Beginning and ending of activity is clearly defined: make sure that the student knows where and when to begin his or her activity and at what point they should end the task. Visual prompts, prompting prior to errors and models: providing students with additional support through the use of visual prompts, verbal cues, and modeling will allow them to be better prepared for the task at hand. Modeling gives children the ability to see the task as it should be performed and also allows for some practice time.

19 Preventative Strategies: When
Additional strategies that look at "when" things are occurring in the student's environment can also impact the person's behavior. Preventative strategies that attempt to change when an event is happening in the environment are often effective at changing the person's behavior, too. Communicating changes in routines: providing students with transition cues prior to changes in daily routines will give them a better sense of what to expect and prepare them for changes in their day. These changes can be posted on a daily schedule with the use of visual prompts or picture cards. Difficult and easy tasks balanced: providing students with a balanced curriculum will allow students to feel success, while learning new material at the same time. For example, if a student is learning new spelling words, intersperse mastered words into the activity so that the student will feel some success with the task.

20 Preventative Strategies: Where
Additional strategies that look at "where" things are occurring in the student's environment can also impact the person's behavior. Preventative strategies can also attempt to change where an event is occurring in a person's environment. Seating arrangements or location of instruction is changed:  often changing a students seat or rearranging seat locations for all students can be a proactive strategy. For a student who needsmore one-on-one attention or has difficulty with directions, moving them to the front of the classroom or closer to the teacher may be helpful.

21 Preventative Strategies: Where
Change in classroom placement: often a move from a restrictive environment to a more inclusive placement can alter behaviors along with providing a student with more opportunities for social interaction and skill building. Transition from the classroom/home to the community: often, classroom settings provide students with a great deal of structure and predictability. Behaviors can be more intense in an environment outside of the classroom for this reason, lack of structure and routine. Providing students with the same type of preventative strategies in the community are ways to proactively address problem behavior and help transfer skills learned in the classroom or home into the community.

22 Strategies and Examples
Strategy Instructional Example Social and Health Example Remove a problem event Avoid difficult independent work Avoid drinks with caffeine Avoid large crowds Avoid long delays Modify a problem event Shorten lesson Modify the content Change instructions Provide visual cues Change voice intonation Use suggestive rather than directive language Consider task difficulty and student preference Intersperse difficult/non-preferred task with preferred task Provide individual schedule Flexible schedule of presentation of task Precede directives with low probability of compliance with high probability directives

23 Strategies and Examples
Strategy Instructional Example Social and Health Example Add events that promote alternative or replacement behaviors Provide choice Include preferred activities Use cooperative learning State expectations clearly Schedule preferred activities daily Involve individual in building schedule Provide functional and meaningful task Block or neutralize impact of negative events Provide frequent breaks during difficult work Modify demands by using behavior momentum or collaboration Provide “rest” time when individual is tired or ill Provide time alone to regroup after negative event

24 Britney's Examples Before you begin to identify preventative interventions on your own, take a look at some preventative strategies that were developed for Britney.  Transition prompts using a timer or verbal cues Adapt curriculum by shorting lessons and adapting difficult task so that Britney would be more successful Implement peer buddy system and rotate student during difficult activities Expand communication and social interaction with teacher assistant Implement social stories at home for changes in routines and/or schedule Provide more movement for Britney in the classroom by developing a variety of work stations

25 Teaching Other Behaviors

26 Developing Interventions
If you completed the practice section successfully, then you are ready to begin the second intervention "teaching other behaviors." Preventing behavior from occurring: Altering the environment Teaching other behaviors: Replacement skills General skills Coping and tolerance skills Responding to behaviors: Changing consequences for problem behavior Lifestyle enhancements

27 Teaching New Behaviors
Preventative strategies alone may not be sufficient for most individuals. It is important to remember that PBS has a teaching component. The person may benefit from learning several different types of skills. Replacement Skills: serve the same function as the problem behavior in a more acceptable and appropriate manner. To reduce problem behavior, at least one appropriate replacement behavior should be identified and taught. Effective behavior support plans enable the individual to reduce undesirable behavior while concurrently increasing desirable behavior. General Skills: are broad skills that modify problem event and prevent the need for problem behavior. Coping and Tolerance Skills: are skills that provide students with strategies to cope with or tolerate difficult situations.

28 Replacement Skills It is important to identify a replacement behavior that is as easy for a student to do as challenging behavior (efficiency). For example: A student is throwing objects around in the classroom during class instruction, in order to get the teachers attention. A very simple and efficient replacement skill could be to teach the student how to raise his hand in order to get the teacher's attention.

29 Considerations When Teaching Replacement Skills
To also insure that students use their new skills more efficiently and effectively it is important to teach others in the student's environment how to respond to the new skill so that it works more effectively that the problem behavior. For example: Kim pinches people in order to get their attention. Teaching Kim to tap others (adults and peers) on the shoulder is more appropriate. However, in order for this new skill to be effective, everyone that interacts with Kim on a daily basis should respond to her when she taps them on their shoulder so that she understands that the new skill is just as effective.

30 Teaching New Skills   Each new skill can be taught independently of each other. However, in some cases depending on the student and the problem behavior, it is possible that you will need to teach the student a replacement skill in conjunction with a coping strategy for difficult and/or frustrating situations or a general skill or both.

31 Strategies and Examples
The following are additional examples of general skills, and coping and tolerance skills. General skills are broad skills that modify a problem event and prevent the need for problem behavior. For example: Organization skills Social interaction Social skills Play skills Self-initiation Choice making

32 Strategies and Examples
Coping and Tolerance Skills are skills that provide students with strategies to cope with or tolerate difficult situations. For example: Relaxation techniques Negotiation skills Conflict resolution Anger management

33 Educative Interventions for Britney
Before you begin to identify responding strategies on your own, take a look at some replacement strategies that were developed for Britney. Replacement Skill: request a break or help: Prompt Britney to ask for a break and/or help during a difficult task (using verbal communication). General Skill: expand expressive communication when Britney uses the word "no" repeatedly. Set up opportunities for communication and reinforce expressive language attempts by asking Britney questions. For example: If you ask Britney to color her paper and she says "no“, in a calm voice, ask her why and what color she would like to use, or if she would like to use markers instead of crayons.

34 Educative Interventions for Britney
General Skill: Increase social interaction skills by paring her with peers during independent and group activities. Assign a rotating peer buddy for Britney. Train her buddies to prompt Britney to stay on task and complete her assignment. Britney can ask her peers for assistance first before asking her teacher. Coping Skill: A count down from 5 to 1 was used with Britney in order for her to control frustrating and upsetting situations.

35 Consequences Interventions

36 Responding to Behaviors
Now it is time to move on to another type of intervention. The next intervention is referred to as "responding to behaviors" Preventing behavior from occurring  Altering the environment Teaching other behaviors  Replacement skills  General skills  Coping and tolerance skills Responding to behaviors: Changing consequences for problem behavior Lifestyle enhancements

37 Defined Consequence interventions are probably the most difficult to
understand and implement because they requires us, the adult, to change the way we respond to the individual's positive and negative behavior. For example, if a student is trying to get the teacher's attention and we stop the lesson and respond to the student every time this student acts out, our attention may be maintaining, and perhaps increasing the problem behavior. Likewise, if we teach the student to raise their hand for attention, it is important that we respond to that alternative skill so that the student views it as or more functional and effective than the problem behavior.

38 Defined If we ignore disruptive behavior and only respond to the alternative skills, it will decrease the use of the inappropriate behavior and increase the use of the alternative skill. In summary, it is important to retain focus on the alternative behavior and continue to teach new ways to meet needs rather than reacting to problem behavior. When responding to an individual's behavior, refrain from reinforcing problem behavior. Rather redirect them to use the replacement behavior.

39 Increasing the Use of Replacement Behavior
If you are trying to increase the use of an replacement behavior for a individual you might consider the following strategies: Consistently honor communicative replacement skill: for example, if you teach a student to raise their hand for teacher attention, it is important for you as the teacher to respond to the student every time they raise their hand for attention. This will allow the student to see that the replacement skill is just as or more effective than the problem behavior. Use positive reinforcement when individual uses replacement skills: positive praise for appropriate attempts and for using the replacement skill will increase the likelihood that the student will continue to use the new skill.

40 Increasing the Use of Replacement Behavior
Consider self-management techniques: once a new skill has been learned, teaching the individual to self-monitor the use of the new skill will allow them to be more aware of their behavior. Redirect (prompt) individual to use replacement skill: it is important, especially in the beginning, to prompt the individual to use his or her new skill rather than resorting to the problem behavior.

41 Changing Outcomes of Problem Behavior
If your purpose is to change the outcome of problem behavior for a student, you can consider the following strategies: Provide corrective feedback: corrective feedback is important for the individual learning the new skill and decreasing the use of the problem behavior. Implement age-appropriate, natural consequence: natural consequences occur as a result of the behavior itself. Natural consequences are typically more meaningful and effective for students.

42 Responding Strategies for Britney
Before you begin to practice identifying responding strategies on your own, here are some responding strategies that were used with Britney: Star system (current behavior management system) was revised so that Britney had more opportunities for rewards and reinforcement throughout the day Responded only to appropriate behaviors and requests Gave Britney positive praise for appropriate behavior Ignored inappropriate responses and problem behavior

43 Lifestyle Interventions

44 Let's move on the last intervention component.
Preventing behavior from occurring: Altering the environment Teaching other behaviors: Replacement skills General skills Coping and tolerance skills Responding to behaviors: Changing consequences for problem behavior Lifestyle enhancements

45 Importance of Quality of Life
An equally important component for students with problem behavior is quality of life. Addressing those issues inside and outside of school that involve individuals with their peers and within the community is a large component. In identifying quality of life adaptations, consider the following: Building relationships and sustaining relationships Using peer cohorts to include in play groups Provide choices throughout the day Develop action plans to integrate into more inclusive/natural settings Sample possible jobs Provide opportunities for after-school activities

46 Britney's Lifestyle Interventions
Here are some additional strategies that were used for Britney: Increase independence in all areas of her life (choices, seat work, self-help skills, etc) Increase appropriate use of social skills Increase peer interactions at school and within the community (join ballet class)

47 Behavior Support Plans

48 Behavior Support Plans
A positive behavior support plan is a plan that is developed for a specific student and addresses specific problem behavior(s). It is individualized and should change over time. A support plan is not a general behavior plan and is not something that cannot be altered or modified.

49 Effective Behavior Support Plans
Use person-centered approaches to planning Are assessment-based (derived from data, classroom observations, etc.) Are hypothesis driven (function of the behavior has been identified) Emphasize replacement skill building and environmental changes as major strategies Usually involve multiple intervention components (preventative skills, educative skills, and responding strategies) Look at behavior change and quality of life outcomes Focus on long-term solutions and sustainability Select needed supports based on team and family involvement Are a good "fit" with individual's home, work, school, and community life

50 Behavior Support Plans Checklist: Guiding Questions
When you are developing a behavior support plan ask yourself these guiding questions in order to insure that your plan has all of the essential components. 1. Is the target behavior clear? 2. What functional assessment methods were used? 3. Is there a clear pattern as to when and where the target behaviors are occurring? 4. Have all environmental variables and triggers been taken into consideration? 5.  Have communicative intents been considered? 6. Is there enough information from the assessment to develop a hypothesis? 7. Are the interventions matched with the hypothesized functions? 8. Have both replacement skills and preventative strategies been considered? 9.  Has the behavior support plan considered all settings and people needed for successful implementation? 10. Has everyone been trained to implement the new plan? 11. Has an evaluation plan for ongoing monitoring and adjustment been developed?

51 Maintenance and Generalization

52 Maintenance and Generalization of Skills
Once you have identified and implemented the various interventions discussed for an individual the next step is making sure the skills are maintained and generalized in different environments. Maintenance strategies are those strategies in place that will provide individuals an opportunity to use and sustain their skills in various environments. Consider the following examples: Teach and support adults in making accommodations Teach and support adults to consistently use an individual's communication system Provide predictability to routines Teach problem-solving strategies Set and monitor goals (self-management)

53 Generalization & Maintenance Strategies: Britney
Here are some interventions that were developed for Britney in order to insure generalization and maintenance of the behavior support plan. They were implemented throughout the day and in all environments. Additional on-going supports were put in place for Britney to insure that: The team continued to meet The teacher continued to take frequency data on behaviors The team communicated meeting times and dates with the PBS project The team would continue to meet monthly regarding transition issues for the next school and identifying next year's teacher.

54 Research Findings In the field of Positive Behavior Support, there are consistent findings in the review of cases that show the effectiveness of the PBS process (National Research Council, 2001). The following are just some findings that show the positive outcomes in the process: Effectiveness in significantly reducing challenging behaviors (at least 50% of cases) Doubled effectiveness when FBA was used to determine function. The FBA process provides the team with more efficient and accurate information regarding the individual Able to be carried out in community settings by caregivers

55 Application Activity As a team, schedule a meeting to develop a Positive Behavior Support plan and a monitoring plan for your focus individual. The monitoring process in PBS is extremely important for your team and for the focus individual. In your plan, remember to include meeting times and team communication, how changes will or can be made to the plan, and most importantly identify a simple way to monitor whether interventions and strategies are successful for the student.

56 Congratulations! You have completed the last training module
in Florida's PBS Project training series: Developing, Implementing and Evaluating Positive Behavior Support Plans We hope that you enjoyed the training modules!

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