Presentation on theme: "Heather Peshak George, Ph.D."— Presentation transcript:
1Heather Peshak George, Ph.D. Session 12 & 17 Complex Functional Behavioral Assessment/ Behavior Intervention PlanningHeather Peshak George, Ph.D.University of South Florida – Tampa BayAugust 17-18, 2010WI PBIS Network: Coaches Training – Stevens Point, WI
2Agenda Overview of Behavior Principles Data Basics Functional Behavior AssessmentData BasicsLevels of Positive Behavior SupportERASE (Liaupsin, Scott, & Nelson)Prevent-Teach-Reinforce (PTR)
3Objectives Participants will: Describe behavioral principles underlying functional assessment of problem behaviorIdentify measures for baseline data gathering and progress monitoringCompare and contrast secondary and tertiary behavior support modelsIdentify key factors that impact intervention effectivenessApply an individualized PBS model
4What Would You Do If…? Paul: Shouts profanities and throws things Kevin: Refuses to respond and turns away from the teacherJenny: Stomps out of class without permission
5Traditional Approaches to Dealing With Difficult Behavior PunishmentExclusionCounseling
6The Problem The child IS the problem so fix him/her Punish the child to teach a lessonWe hope the problem will go away…Does it?Who benefits the most from this approach?The child HAS a problem so fix itChange the environmentTeach new skillsProblem less likely to occur
7Comparison of Traditional Behavior Intervention Plans and Positive Behavior Intervention Plans Traditional BIP:Focuses on the student needing to be changedEliminating undesirable behavior is the goalUses mostly reactive strategies (consequence-based)Usually includes punitive interventionsPositive BIP:Focuses on the context/environmentGoal is to replace problem behavior with a functionally equivalent behavior or skillUses multi-component interventionsPreventativeReplacement behaviorResponding/Reinforcement
8Given 60 seconds, use 4 straight lines to connect all of the dots without lifting your pen
12Behavior Anything we say or do Much easier to change things we can observeThink about whether you can see or hear itWhat about thoughts? Intentions?Best not to focus on these as becomes more of a guessing game
13How are Behaviors Learned? Stimulus/Antecedent (Sd)BehaviorConsequences/ Reinforcement
14Increasing Behaviors 2 Categories of Reinforcement Positive Negative Addition of pleasant stimulus after behaviorExample: getting a popsicle when you say “popsicle”School examples: verbal praise, earning points, stickers , stars, access to preferred activities…..NegativeRemoval of unpleasant stimulus when target (desired) behavior occursExamples: 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 interactionConditions 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.
15Decreasing Behaviors Punisher Addition of an unpleasant stimulus after behavior that decreases the likelihood that behavior will be performed in the futureIf 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?
16Use 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 themWhat happens in the main office, the behavior specialists’ or counselors’ office at your school?
18Function 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.ContextThings in the environment (items, persons, actions, events) affect the likelihood of a behaviorFacilitator 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.
19Functional Behavior Assessment Purpose:Assess behavior in relation to environmental contexts (antecedents and consequences)To identify the function(s) maintaining problem behaviorTo guide the development of an individualized, data-based behavior support plan
20Functional Behavior Assessment More than just paperwork to meet IDEAMore than just a step before a diagnosis or placement change is madeAn ongoing process, not an eventIs a tool to:Change the environment to make behavior less likelyTeach the student new skillsSet the student up for success
21The FBA Process Identify and define problem behavior Identify patterns of problem (and appropriate) behavior-- antecedent and consequent eventsIdentify the function of behavior—hypothesisDevelop an intervention planMonitor the effectiveness of the intervention
22Identify Problem Behavior The definition needs to be operationalizedObservableMeasurableAccurateDetailedCan you hear it, see it?
23Define Problem Behavior Non-ExamplesTantrumHyperactiveAngryAggressiveExamplesScreams, falls to floor, pounds fists on the floorJumps out of chair w/o permission; shouts responsesThrows materials on the floor when asked to do math tasksPunches peers on their body with his fists
24Identifying Patterns: Methods To Collect FBA Data
25Functional Behavior Assessment/ Gathering Information IndirectRecord ReviewInterviewing—PTR AssessmentChecklists—ERASE/PTR AssessmentDirectScatter plotsABC Data Collection—ABC CardSelect best ways to gather information about operationalized behavior
26The ABCs of BehaviorA = AntecedentB = BehaviorC = Consequence
27ABC Analysis Antecedent: Behavior: Consequence: What happens immediately before the behavior?Behavior:The actions of the studentConsequence: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.
28ABC ABC Behavior Antecedent Consequence What a Person Says or Does Medical & PhysiologicalEnvironmentalCurricular & InstructionalInteractionalPersonal & Control IssuesWhat a PersonSays or DoesSocial/attentionTangible Escape/avoidanceSensory/intrinsicUnder what circumstances does behavior occur?What outcomes are produced?
29ActivityAs a group, determine the function of behavior for the next two studentsAnswer using your hands (appropriately): Right hand up: EscapeLeft hand up: AttentionBoth hands up: SensoryBoth hands down: I am not paying attention
30Activity: ABC Analysis JOHN LEAVES CLASS WITHOUT PERMISSION – WHY?All things that happen just before behaviorAll things that happen just after behaviorThe student’s behaviorJohn 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 classroomTeacher 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 funABC 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.
31Activity: ABC Analysis BRENDA HITS OTHER STUDENTS - WHY?All things that happen just before behaviorThe student’s behaviorAll things that happen just after behaviorSusan calls Brenda a “creep face” and laughs at herBrenda punches Susan on the armSusan 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)
32Antecedents (Before Behavior) Two typesSlow trigger (setting events)Removed in time from the occurrence of behaviorFast trigger (immediate antecedent)Events happen immediately before the problem behavior
33Antecedents: Slow Triggers May happen in or out of the classroomAre conditions that increase the likelihood behavior will occuroversleepingno breakfastforgotten medicationconflict with . . .
34Antecedents: Fast Triggers ExamplesAssignment to easy/difficultTeasingTeacher attending to another studentMay be consistentAnytime someone asks student to open bookMay only occur when specific event occursOnly when Ms. Jones asks student to open book
35Consequences of Behavior Responses and/or events occurring after problem behaviorWhat is the pay-off?What does the student get?What does the student avoid?
37Using Data to Develop a Hypothesis: Your Best Guess
38What is a Hypothesis Statement? A hypothesis statement is:an informed, assessment-based explanation of the target behavioran informed “best” guess about the relation between environmental events or conditions and student’s target behavior
39Hypothesis Development FormulaWhen (trigger/antecedent/setting event) occurs….the student does (describe behavior)…to (obtain or escape or avoid)…..(function)
40Hypothesis 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).
41Activity 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
42Are 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
43Using the Data-Based Hypothesis to Develop a Behavior Intervention Plan
44Behavior Intervention Plan The intervention plan is a plan that:is developed for a specific studentaddresses specific challenging behavior(s)provides enough detail for anyone to implementThe intervention plan is nota general behavior plana list of suggestions
45Selecting Interventions Select interventions that will make problem behavior:Irrelevant—Antecedent or Prevent InterventionsChanges to the environment (the triggers) so that problem behavior is not necessaryInefficient—Replacement Behaviors or TeachNew behavior is easier and results in a faster outcome than the problem behaviorIneffective—Responding to Behavior or ReinforceResponding so that new behavior has the same outcome as problem behavior but greater than problem behavior
46Replacement Behaviors Replacement behaviors are what we want the student to do instead of the problem behaviorEffective replacement behavior must:Be incompatible with the problem behaviorServe the same function as the problemProblem BehaviorFacilitator 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.FUNCTIONREPLACEMENTBehavior
47Two Types of Replacement Behaviors Functionally equivalentMore appropriate way to get the same outcomeNot the expected or desired behaviorIntermediary behavior that will be fadedAsking for a break, brain break pass, secret signal for attention, work check pass, tardy pass, requesting cool off or calming strategyDesired, prosocialBehavior expected of the student to get the same or different outcomeRaising hand, asking for item, completing assignment, coming to class on time, transitioning
48Activity: Identify Replacement Behaviors For each behavior listed in the table:Identify one functionally equivalent, intermediary behaviorIdentify one desired, expected behavior
49Identify Replacement Behaviors Problem BehaviorFunctionReplacement BehaviorRefusing to transition to next activity in classDelaying/avoiding transitionRefusing to answer in front of peersEscape peer attention or embarrassmentLeaving class without permissionEscape boring (repetitive) tasksShouting cuss words at adults and peersGet 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.
50Identify Replacement Behaviors Problem BehaviorFunctionReplacement BehaviorRefusing to transition to next activity in classDelay/avoid transitionR: Request short delay of transitionr: Transition to next activityRefusing to answer in front of peersEscape peer attention or embarrassmentLeaving class without permissionEscape boring (repetitive) tasksShouting cuss words at adults and peersGet 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.
51Identify Replacement Behaviors Problem BehaviorFunctionReplacement BehaviorRefusing to transition to next activity in classDelaying/avoiding transitionRefusing to answer in front of peersEscape peer attention or embarrassmentR: Cue/pass to not answerR: Answer questionLeaving class without permissionEscape boring (repetitive) tasksShouting cuss words at adults and peersGet 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.
52Identify Replacement Behaviors Problem BehaviorFunctionReplacement BehaviorRefusing to transition to next activity in classDelaying/avoiding transitionRefusing to answer in front of peersEscape peer attention or embarrassmentLeaving class without permissionEscape boring (repetitive) tasksR: Request breakr: Stay in class and work on taskShouting cuss words at adults and peersGet 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.
53Identify Replacement Behaviors Problem BehaviorFunctionReplacement BehaviorRefusing to transition to next activity in classDelaying/avoiding transitionRefusing to answer in front of peersEscape peer attention or embarrassmentLeaving class without permissionEscape boring (repetitive) tasksShouting cuss words at adults and peersGet peer’s attention and respect for being a “bad a_ _”R: Ask for attentionr: 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.
57“Sam”KindergartenAggressive with peers, not participating in activities or following routines, difficulty focusing on any activityECC program red flagged him due to behavior and lack of academic progressDCFS involved
58Summary Statement Function Coupons, Follow routines praise DesiredAlternativeTypicalConsequenceCoupons,praiseFollow routinesSetting EventsTriggeringAntecedentsProblemBehaviorMaintainingConsequencesConflict at home: mornings whennot organized for school, not sure who will take Sam to schoolDoes not join activitywalks around the classroom, poking and pushing kidsmorning activity when teacher requests that he sit on chair or carpet for structured activitygives a time out to calm down misses activitiesFunctionReplacementBehaviorsWalk to a designatedarea of classroom
59Setting EventManipulationsAntecedentManipulationsBehaviorManipulationsConsequenceManipulationsRe-teach expected behavior for all classroom settingsAdditional rating periods for expectationsIndividualized positive greeting by teacher in the morningWalk 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 roomTeach how to sit and complete tasks for 5minutes up to 10 minutesPoints/coupons when participates in activities or quietly goes to his “area”Does not earn points if puts hands on students
60Moving from Brief FBA/BIP to Complex FBA/BIP Team developing plan became more individualizedAdditional data tool used—Educational Information ToolBIP strategies applied in multiple settings (home and school).
61Summary Statement Function Coupons, Follow routines praise DesiredAlternativeTypicalConsequenceSummaryStatementCoupons,praiseFollow routinesSetting EventsTriggeringAntecedentsProblemBehaviorMaintainingConsequencesConflict at home: problem behavior at home before schoolDoes not complete work, throws things, laughs, disturbing othersStructured academic tasksTeacher walks over, talks to him and helps him get on taskFunctionReplacementBehaviorsAsk teacher for help
62Setting EventManipulationsAntecedentManipulationsBehaviorManipulationsConsequenceManipulationsMore re-teaching for whole class, how to quietly workHigher rates of praise during activitiesUse timer so all kids could see how much time they had for activityCousin 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, pointsTeach how to ask for helpTeach how to work in close proximity to peers --sharing supplies and asking for help from peersPoints earn extra playtime of choice at end of classPlanned ignoring of problem behaviorReward at home when earns DPR points
63Self Check for Designing Support Plans Prevention StrategiesDoes 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?
64Self Check for Designing Support Plans Teaching StrategiesDo 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?
65Self Check for Designing Support Plans Reinforcement StrategiesDoes 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?
66Evaluation: 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
67Baseline DataMust have a method to collect data prior to start of interventionMust track problem behaviorShould track appropriate behavior or what you want the student to be doing insteadNeed a minimum of 5 days of data prior to intervention
68Progress MonitoringContinue collecting data daily after intervention implementedNeed to use same method of data collectionMay need to add specific replacement behavior to data collection
69Developing Measurement Plan Identify outcomes most important to the teamKeep It Simple--“KIS it”Simple, user-friendly forms to monitor outcomesRating scales, check sheetsSchedule dates for check-insUse the data!!Evaluate the effectiveness of the support plan at least weekly
71The Behavior Rating Scale A rating of the recorder’s perception of the occurrence of behaviorExtremely effective in getting dataTime efficientMeasure of change in behaviorCompleted as a whole day measure or during specific times of the dayRecorder scores on a scale of 1 to 5 that is defined for each behavior
72Requesting Attention/ Behavior Rating ScaleBehaviorDateHitting8 or more6-7 times4-5 times2-3 times0-1 times54321Profanity16 or more times12-15 times8-11 times4-7 times0-3 timesRequesting Attention/Assistance55% or more40-55%25-40%10-25%0-10%
73Data Gathering Measure—Jack (Leaving Class W/O Permission Week of _____________MondayTuesdayWednesdayThursdayFridayEnglishPre-AlgebraWorld HistoryComputer LabStudy LabAverage ScoreAverage Score:188.8.131.52Change to a middle school/high school exampleRate 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
74Ben’s Playtime 3=Cooperated, stayed briefly 2=Fussed, took several turns1= Cried, refused to play4=Laughing, stayedMondayTuesdayWednesdayThursdayFridaySaturday4321
76Importance of Team-Driven Actions Greater likelihood of teacher buy-inGreater likelihood of intervention implementationProblem-solving process becomes broaderTeacher ownership of “problem” increasesRelationship with facilitator and impact on intervention acceptanceMust be collaborativeCannot come in and tell teacher what to do
77Behavior Support TeamA collaborative group of individuals who assess and develop individualized, proactive, continuing supportsInformation GatheringHypothesis DevelopmentCreation of the Support PlanImplementation of Interventions
78Membership on Behavior Support Teams People who know the focus student well and have a vested interestPeople who know supports and resources (and methods of accessing them), as well as potential barriersMembers to allocate personnel and fiscal resources
79A Tiered Approach to Meeting Individual Student Needs
80Individualized PBS (Tertiary) For high-risk students:History of severe problem behaviorsDemonstrated resistance to interventionAn 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
81Which Students Need PBIS? Address Individual level PBIS if:One or more students receive many referralsOne or more students exhibits severe or dangerous behaviorSchool-wide screenings and teacher referrals identify students with problem behaviorSchool-wide, classroom, or targeted group interventions have not resulted in improved behavior for one or more studentsStudents in ESE settings with persistent or violent behavior who may not generate office referralsExamine 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.
82Office 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
83Why ODRs May Not Be Enough May miss students in ESE settings with persistent or violent behavior who may not generate office referralsMay not identify students with severe “internalizing” behaviorsMay not identify students with many “minors” but few “majors”May not reflect that some teachers write referrals and others do not
84Other Ways to Identify Students Behavior screenings1-2 times per year teachers “nominate” and rank studentsTeachers complete validated rating scale (CBCL-TRS or SSBD)Teacher referralsIdentify concernPrioritize within classroomMust have a process to prioritize identified students
85Activity: 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?
87Principles of Practice Levels of support range from simple classroom consultation to intensive wrap-around plansAll levels include data collection and functional behavior assessmentAll levels match interventions to functions of behavior and the school’s contextIndividualized 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.
88How to Make PBIS Work Be pragmatic Effectively and efficiently match your resources to the complexity of the behavior problemSerious/complex behavior problems = additional resources and approachesLess intensive behavior problems = fewer resources
89System Changes to Consider System for submitting a request for assistanceForm, to whom, where, what information is needed?System for prioritizing studentsIdentify who will facilitate teamsSystem for notifying other team membersIdentify a set a time period until a baseline data meetingIdentify a set time period until intervention meeting
91Purpose of P-T-RTo 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
92PTR Model Research-based Practices Team-driven decision-making Assessment and InterventionTeam-driven decision-makingSteps are scripted as much as possibleEach step ends with self-evaluation (checklist)Selection of interventions is menu-drivenEntire process is manualized
93The PTR 5-Step Process Developing a Team Establishing clear goals (short and long term)Functional AssessmentDesigning and Implementing a Behavior Intervention PlanEvaluation (ongoing) and Revision (as necessary)
94Step 1: Overview Team Building Team DevelopmentInclude: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; andOthers, such as family members, paraprofessionals, special area teachers.Team functionRoles and ResponsibilitiesBehaviors and Commitment
95Step 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 SurveyParaeducator Work Style SurveyClassroom Team SurveyA collaborative processTeacher and facilitator relationship
96Step 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 memberIdentify a consensus-making process
97Case Study—Step 1: Team Building Mike is a 9-year-old male in a self-contained autism classroomNonverbal—uses signs, Dynamite, and pictures to communicate1 teacher, 2 aides, and 6 students
98Case Study—Step 1: Team Building Teacher-- Ms. WonderfulAidesMs. Needs HelpMs. Also Needs HelpFacilitator—PTR ConsultantResults of teaming information indicate a great team that meets regularly to brainstorm
99Step 2: Overview Goal Setting Team engages in a process for identifying problem behavior and possible replacement behaviors to target in 3 areas:AcademicSocialBehaviorTeam defines short term goals in operational and measurable termsTeam prioritizes short term goals and develops a baseline data collection system
100Step 2: Goal Setting Identifying Behavioral Goals Address school-based events that can be changed within the school yearProblem Behaviors & Replacement BehaviorsLeaving class without permissionRemaining in class throughout the period and/or requesting a breakSocial Deficits & Social SkillsUsing profanity when mad at peers & adultsExpressing frustrations and needs appropriatelyAcademic Behavior & Pro-Academic SkillsNot finishing work/completing work independentlyDisengaged/Engaged during independent work time
101Step 2: Goal Setting Identifying Behavioral Goals SocialAcademicBroadThe broad skill or outcome the student needs to learn (e.g., communicate wants/needs, initiate peer interactions, task engagement)DecreaseWhat the student is doing now that is keeping him/her from meeting the broad goalIncreaseThe more specific behavior the student should engage in to meet the broad goal
102Case Study—Step 2: Goal Setting BehaviorSocialAcademicDecreaseIncreaseBroadMike will communicate his wants and needs appropriatelyMike will interact with peers appropriatelyMike will comply with nonpreferred activities and requestsMike will decrease screaming, hitting, and getting out of his seatMike will decrease hitting, screaming at, and bossing his peersMike will decrease screaming and hittingMike will ask for a break or for attention when neededMike will initiate peer interactions using his DynamiteMike will engage in nonpreferred activities and communicate his frustration using his Dynamite or an appropriate tone
103Step 2: Identify Baseline Data Collection System Baseline data gatheringIdentify no more than 3 problem behaviors of concern and the skills to replace (increase)Operationally define all targeted behaviorsIdentify how and when data will be collectedNeed at least 5 days of baseline data
104Case Study: Operational Definitions of Problem and Replacement Behaviors Screaming—loud, high pitched noise heard outside the classroomHitting—anytime Mike touches peers or adults with an open hand, fist, foot, or object while screaming or protestingExpressing Frustration—using Dynamite, pictures, or signs to ask for a break or attentionTransition to nonpreferred activities—moving to nonpreferred activity and engaging with appropriate verbal expression (screaming level)
105Case Study: Behavior Rating Scale With Anchors DateScreaming9+ times7-8 times5-6 times3-4 times0-2 times54321Hitting8+ times6-7 times4-5 times2-3 times0-1 timesExpressing Frustration40%+30-40%20-30%10-20%0-10%Transition to NonpreferredWhimper or squealLouder than indoor voiceOutdoor play voiceLouder than outdoor playEar penetrating
106Using the Behavior Rating Scale (BRS) Perceptual ratingBehavior recorded at least once dailyMay be specific to a setting, activity, time of dayMay be whole dayMay be combination of bothUse anchors on a scale of 1-5
107Determining the Anchors on the BRS Behavior can be measured usingFrequency (times per day)Duration (hours, minutes, seconds)Intensity (how hard, how loud, bruise, etc.)Percent of dayPercent of occurrencePercent of opportunity
108Questions 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?
109Step 3: Overview PTR Assessment (FBA) Each team member independently answers a series of questions related to:Observed antecedents/triggers of problem behaviorsFunctions of the problem behaviorsConsequences ordinarily associated with the problem behaviorsSynthesized input leads logically to development of three intervention components (prevent, teach, reinforce)
110Step 3: PTR Assessment The Assessment Summary Table All responders’ answers reflected on summary tableGroup/organize responses into similar categoriesPreventSpecific subjects, information about curriculumTransitions (within and to/from classroom)Unstructured times (e.g., centers, recess, free play)Setting events/slow triggers (e.g., temperature, meds, sleep, illness)Teach—FunctionsAttention seekingEscapeAccess to items/peopleReinforceConsequences resulting in attention, access, and/or avoidanceIdentify questions that need answers
111Case Study—Step 3: PTR Assessment Problem Behavior Prevention DataTeach DataReinforce DataNon-preferred taskReading, MathTransitionPreferred tonon-preferredChange in scheduleDenied item, told no, or to fixsomethingOther students upset/madTeacher attending to othersGain attentionPeers, adultsDelayAccess to itemsRedirectedReprimandedCalm/soothePersonalspaceLater mustcomplete taskLoses/delaysreinforcersScreaming, Hitting
113Step 3: PTR Assessment—Developing the Hypothesis When….Student will….As a result…Inappropriate BehaviorAppropriate BehaviorPrevention data = antecedents or triggersTeach data = replacement behavior and possible functionReinforce data = function and reinforcers
114Case 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 studentsscream and hitMike is able to gain attention and delay the transition/activityMike 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 studentsexpress his frustrations appropriatelycomplete the assigned taskMike is able to delay the transition/activityMike is able to gain attentionInappropriateAppropriate
115Step 4: Overview of PTR Intervention Team identifies appropriate interventions for each component (prevent-teach-reinforce) from a menu of optionsBehavior intervention plan developedConsultant provides training and on-site assistance for final interventions agreed uponFidelity of implementation is tracked
116Step 4: PTR Interventions List of Activities to Address Review Intervention ChecklistDiscuss interventions selectedDo 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 trainingDiscuss in-class coaching/technical assistanceDiscuss fidelity
118Step 4: PTR Intervention Using the Intervention Checklist Record each team member’s rank on the checklistDevelop a list of preferred interventionsMean of ratingsInterventions rank ordered #1Number of people selecting specific intervention*Be sure to make note of interventions ranked highest/selected by teacher
119Step 4: PTR Intervention Developing the Intervention Plan Guide the team to identify interventionsUse Intervention ChecklistProvide examplesAsk them questionsHow might this strategy look for student?Are you going to always be available?Is this doable?Ensure fit with the classroomEnsure fit with the function
120Case Study: Tips on Linking Interventions to Hypothesis Prevention strategies must address:Getting Mike attention more oftenChanging non-preferred taskParticular studentHow it is done (format)Changing what happens when he makes a mistakeDo part of it (rather than all of it) overAllow him to find what is wrongProvide social storySignaling end of preferred activityTeach strategies must address:How to get attention/assistanceHow to get break/delay appropriatelyReinforce strategies must address:Giving Mike attention/helpGiving Mike break/delay
121Step 4: PTR Intervention Writing the Intervention Plan Task analyze each step of the planNOT— “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 strategyMake it easy for teachers to do!!
122Case Study—Step 4: PTR Intervention Prevent StrategiesSpecific Strategy stepsEnvironmental SupportA 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.
123Specific Strategy steps Prevent StrategiesSpecific Strategy stepsCurricular ModificationMike 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
124Specific Strategy Steps Teach StrategiesSpecific Strategy StepsReplacement BehaviorMike 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
125Specific Strategy Steps Teach StrategiesSpecific Strategy StepsSelf-ManagementMike 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
126Specific Strategy Steps Reinforce StrategiesSpecific Strategy StepsReplacement BehaviorAnytime 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 minute4. Praise him as soon as he is quiet5. Praise him for returning to the groupSelf-ManagementAnytime 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.WaitingMike will earn a skittle paired with attention if he waits. This will be faded to an intermittent schedule.
127Specific Strategy Steps Reinforce StrategiesSpecific Strategy StepsTransitionMike 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.
128Step 4: PTR Intervention Teacher Training on BIP Provide training to practice the plan without studentAsk the team questions to ensure understandingHave team role-play stepsObtain 80% accuracy on each step prior to teacher implementing plan with studentCoaching Checklist is task analysis of plan
130Step 4: PTR Intervention In-Class Coaching Provide X hours in the classroomModel the planWork with other studentsProvide feedbackSuggest modifications as neededQuality of time rather than quantity
131Step 4: PTR Intervention Fidelity Must measure teacher implementationAdherence—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?
132Step 4: PTR Intervention Fidelity Example: Staying in Class Task analysis of steps of intervention to make leaving class without permission irrelevantPrevent intervention—Curricular ModificationHypothesized function—escapeAntecedents 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 outcomesPresent modified assignment to student (and others in class if appropriate)Review assignment, provide examples of completed workRemind student of reinforcement for completing assignment
133Step 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 studentQuality--What are all of the steps the teacher needs to do?Ensure modification embeds preferences, is at appropriate difficulty levelReviews assignment and reinforcement
135Step 5: EvaluationIs it working?Daily ratings of behaviorContinuous progress monitoringBRSOther data collection formsIs it being implemented consistently and accurately?Fidelity ratingsIs more data needed?Does the plan need to be modified or expanded?
137Step 5: Evaluation1 is a lot of screaming, 5 is no screaming
138Step 5: Evaluation1 is a lot of hitting, 5 is no hitting
139Step 5: Evaluation1 is a little appropriate expression, 5 is a lot of appropriate expression
140Step 5: Evaluation1 is inappropriate transition, 5 is super appropriate transition
141Review PTR Process Five-step team-based process Meetings last minutesTraining of teacher in BIPIn-class coaching providedIntervention process averages 3 months
142Review of PTR Process: Adapt Process as Needed Combine stepsSteps 1 and 2 (teaming and goal setting)Smaller team or team with no history of problemsSteps 2 and 3 (goal setting and assessment)Complete step 2 and 3 activities prior to meetingComplete step 3 activity (PTR assessment) during the meetingSteps 3 and 4(assessment and intervention)Complete assessment in meeting and go right into intervention development
143Administrative Responsibilities: Tier 3 Identify Tier 3 resources and training as neededEnsure infrastructure in place w/quality reviewsCollaborative consultation (MDT & knowledge)Identification and prioritizing of students in needData system w/meaningful data & data-based decision-making timeTime for planning, implementation & progress monitoringWillingness to try “out of the box”, evidence-based interventionsRecognize the “workhorses” on your team
144Final Thoughts: System Changes Process may require more time up front but less time overallTeams more likely to implement the planOwnershipFits the class and the studentContinued contact
145Absolute Essentials of PTR A functional teamCollaborative, respectful, committedPTR assessment conducted with precision – the more precise and the more confident the team is with assessment results, the more effective the intervention will be3 components in intervention (at least) – linked to assessment, implemented with fidelitySensible data collection, and periodic review, revision, celebration, etc.
146Potential Reasons Need additional help to address behavior Identification of functionDirect observation of behaviorConsistency of interventionNot a complete teamAdditional interventions – not a complete planComplexity of behaviorNeed for Wraparound Model or other additional supports