1. Promoting Social Emotional Competence Individualized Intensive Interventions: Determining the Meaning of Challenging Behavior Module 3a

2. Agenda Introduction Challenging Behavior Overview of PBS Behavior Equation The Process of PBS, Building a Team Introduction to Functional Assessment Functional Assessment Observation Conducting Observations, Data to Collect Functional Assessment Interview Case Study Activity: Determining the Function Hypothesis Development Not Sure about The Hypothesis 2

3. Learner Objectives This workshop will teach you to: Define forms and function of communication and identify the behavioral mechanisms that contribute to viewing challenging behavior as communicative Describe methods that may be used to determine the function of challenging behavior Use interview and observation data to determine the communicative function of challenging behavior Develop a behavior hypothesis from functional assessment information 3

4. Challenging Behavior What we are referring to when we say “challenging behavior” is: Any repeated pattern of behavior that interferes with learning or engagement in pro-social interactions with peers and adults Behaviors that are not responsive to the use of developmentally appropriate guidance procedures. Prolonged tantrums, physical and verbal aggression, disruptive vocal and motor behavior (e.g., screaming, stereotypy), property destructions, self-injury, noncompliance, and withdrawal 4

6. Promoting Social Emotional Competence Creating Supportive Environments Building Positive Relationships Social Emotional Teaching Strategies Individualized Intensive Interventions 6

7. Intensive Individualized Instruction Intensive individualized instruction and interventions are used with children who have very persistent and severe challenging behavior and do not respond to the typical preventive practices, child guidance procedures, or social emotional teaching strategies that would normally work with most children. 7

8. Old Way New Way General intervention for all behavior problems Intervention is reactive Focus on behavior reduction Quick Fix Intervention matched to purpose of the behavior Intervention is proactive Focus on teaching new skills Long term interventions 8

9. Challenging Behavior Communicates May be used to communicate a message when a child does not have language 9

10. Challenging Behavior Communicates May be used instead of language by a child who has limited social skills or has learned that challenging behavior will result in meeting his or her needs 10

11. Challenging Behavior Children engage in challenging behavior because “it works” for them. Challenging behavior results in the child gaining access to something (i.e., obtain) or avoiding something (i.e., escape). 11

12. Children Communicate a Variety of Messages Forms of communication Words Sentences Eye gaze Pulling adult Crying Biting Tantrums ? 12

13. Children Communicate a Variety of Messages Functions of communication –Request object, activity, person –Escape demands –Escape activity –Request help –Request social interaction –Comment –Request information –? 13

14. Evan Evan is playing with Duplos. He tries to attach a block to his stack of 3. He can’t quite get the blocks to connect. He looks up at a teacher and begins fussing. He holds the stack of blocks up, looks at the blocks, and looks at the teacher. The teacher helps him put the blocks together. 14

15. Shana Shana is sitting in her high chair with nothing on the tray. Her mother is stirring her oatmeal. Shana begins crying and bangs her head on the back of the seat. Her mother says to her, "It's not cool enough, honey, just a minute." Shana stops crying when the oatmeal is placed on her tray. 15

16. Christina Christina wanders into the kitchen where her mother is cooking. She looks around the kitchen and at the tray of her high chair. She moves to the refrigerator and looks at her mom. She begins crying and reaching toward the refrigerator. Her mother takes out a bottle, warms it, and gives it to her. 16

17. Tim Tim is riding a trike on the bike path. He sees a child move to the sandbox where he had just finished building a road-way. He leaps off his trike and tackles the child. He hits the child. A teacher comes over to intervene. She comforts the child, and scolds Tim. Tim goes to the sandbox and continues construction on his road-way. 17

18. Madison Madison is in housekeeping, putting on high heels and a hat. Emily moves into the area and selects a purse from the dress-ups. Madison shouts “no” and bites Emily. A teacher comes over, she asks Madison to go to the thinking chair and takes Emily to the bathroom to look at the bite. After 4 minutes, Madison leaves the thinking chair and returns to housekeeping. She grabs the purse Emily had selected and continues to play. Emily leaves the bathroom with the teacher and then begins an art activity where the teacher is present. 18

19. Kyra Kyra sees three children playing with the train set. She watches them carefully. She grabs one of the trains and holds it. The children call for a teacher. The teacher comes over, asks about what happened, and then prompts Kyra to ask to play. Kyra complies and joins the group. The children reluctantly allow her to join the group. 19

20. Trigger Behavior Maintaining Consequence Joey is asked to come to circle. Teacher provides physical prompt to move him to group. Joey resists, cries, and hits teacher Teacher moves away from Joey and allows Joey to select a different activity. 20

21. Setting Event Event that occurs at another time that increases the likelihood the child will have challenging behavior. Setting events serve to “set the child up” to have challenging behavior. 21

22. Setting Trigger Behavior Maintaining Event Consequence Quan approaches computer and sees child working on program. Quan moves his picture to indicate that he is next. Quan observes and waits for his turn. Child leaves computer and Quan sits down and begins working. 22

23. SettingTrigger Behavior Maintaining Event Consequence Quan was up most the night with an asthma attack. He arrives at school looking sleepy and with dark circles under his eyes. Quan approaches computer and sees child working on program. Quan hits child and pushes his body on the child’s chair. Child leaves computer and Quan sits down and begins working. 23

24. Evan Evan is playing with Duplos. He tries to attach a block to his stack of 3. He can’t quite get the blocks to connect. He looks up at a teacher and begins fussing. He holds the stack of blocks up, looks at the blocks, and looks at the teacher. The teacher helps him put the blocks together. 24

25. Shana Shana is sitting in her high chair with nothing on the tray. Her mother is stirring her oatmeal. Shana begins crying and bangs her head on the back of the seat. Her mother says to her, "It's not cool enough, honey, just a minute." Shana stops crying when the oatmeal is placed on her tray. 25

26. Christina Christina wanders into the kitchen where her mother is cooking. She looks around the kitchen and at the tray of her high chair. She moves to the refrigerator and looks at her mom. She begins crying and reaching toward the refrigerator. Her mother takes out a bottle, warms it, and gives it to her. 26

27. Tim Tim is riding a trike on the bike path. He sees a child move to the sandbox where he had just finished building a road-way. He leaps off his trike and tackles the child. He hits the child. A teacher comes over to intervene. She comforts the child, and scolds Tim. Tim goes to the sandbox and continues construction on his road-way. 27

28. Madison Madison is in housekeeping, putting on high heels and a hat. Emily moves into the area and selects a purse from the dress-ups. Madison shouts “no” and bites Emily. A teacher comes over, she asks Madison to go to the thinking chair and takes Emily to the bathroom to look at the bite. After 4 minutes, Madison leaves the thinking chair and returns to housekeeping. She grabs the purse Emily had selected and continues to play. Emily leaves the bathroom with the teacher and then begins an art activity where the teacher is present. 28

29. Kyra Kyra sees three children playing with the train set. She watches them carefully. She grabs one of the trains and holds it. The children call for a teacher. The teacher comes over, asks about what happened, and then prompts Kyra to ask to play. Kyra complies and joins the group. The children reluctantly allow her to join the group. 29

30. Process of Positive Behavior Support Step 1: Establishing a team and identifying goals of intervention Step 2: Gathering information (functional assessment) Step 3: Developing hypotheses Step 4: Designing behavior support plans Step 5: Implementing, monitoring, and evaluating outcomes 30

31. Potential Team Members Parents/Family Teacher Assisting Teacher/Paraprofessional Therapists Administrative Staff Other 31

32. Process of Positive Behavior Support Step 1: Establishing a team and identifying goals of intervention Step 2: Gathering information (functional assessment) Step 3: Developing hypotheses Step 4: Designing behavior support plans Step 5: Implementing, monitoring, and evaluating outcomes 32

33. Functional Assessment A process for developing an understanding of a person’s challenging behavior and, in particular, how the behavior is governed by environmental events. 33

34. Functional Assessment Observe the child in target routines and settings Collect data on child behavior, looking for situations that predict challenging behavior and that are linked with appropriate behavior Interview persons most familiar with the child Review records Click on link to review Jackson’s FAI H3a.4J.pdf H3a.4J.pdf 34

35. 231 4 7 5 8 *0 6 9 # 35

36. 231 4 7 5 8 *0 6 9 # ABCDEF PQRS GHI TUV WXYZ MNOJKL OPER TONE 36

37. Name: General Context: Observer: Date: Time: Social Context: Behavior Problem: Social Reaction: POSSIBLE FUNCTION: 37

38. Observation Vignette #1

39. Name: SEGMENT 1 General Context: Choice time Observer: Date: Time: Social Context: Playing alone in block play. Goes over to a group of children playing. Behavior Problem: Sticks out tongue and makes raspberry sound, hits boy, scratches his shoulder. Social Reaction: Boy yells at him, friend brings him a lizard, boy yells to teacher. POSSIBLE FUNCTION: Initiate social interaction/Join play 39

40. Observation Vignette #2

41. Name: SEGMENT 2 General Context: Playground Observer:Date: Time: Social Context: Playground play with 2 friends. Girl goes to basket and gets truck just like the other friend’s truck. Behavior Problem: He tries to take her truck, shoves, pushes, and continues tugging for toy. Social Reaction: Gets toy for a second, continues to fight girl for toy, teacher reprimands and carries him away. POSSIBLE FUNCTION: Obtain the toy (same truck as “best friend’s”) 41

42. Observation Vignette #3

43. Name: SEGMENT 3 General Context: Computer Observer:Date: Time: Social Context: Brother is having a turn at the computer. Brother sits. Mom Says, “1. Josh 2. Brendan.” Brendan says, “It’s Brendan’s turn.” Behavior Problem: B. yells, falls to ground, pulls chair, kicks, cries. Social Reaction: Josh protests, mother says, “Do you want me to carry you?” B. says,“Carry me.” She carries him away. POSSIBLE FUNCTION: Obtain computer/Adult attention 43

44. Observation Vignette #4

45. CSEFEL Name: SEGMENT 4 General Context: Enter Library Observer:Date: Time: Social Context: Going into library. Mother says, “Let’s go inside.” Then she counts down. Behavior Problem: Drops to floor, resists moving, screams, kicks, tries to run, drops, resists, screams, becomes “wet noodle.” Social Reaction: Mother pulls him through doors then picks him up as he resists. POSSIBLE FUNCTION: Escape/avoid going into the library (prolonged) (and adult attention) 45

46. Observation Vignette #5

47. Name: SEGMENT 5 General Context: Circle with puppet Observer:Date: Time: Social Context: Teacher kisses children’s cheeks with puppet. Says, “Say good-bye to MiMi” Teacher gets up to put away puppet. Behavior Problem: Hitting self on head with fist, pull at shirt Social Reaction: Adult says “Ryan, ready to dance? Want to dance Ryan?” Goes and sits in her lap and is happy. POSSIBLE FUNCTION: Adult attention 47

48. Observation Vignette #6

49. Name: SEGMENT 6 General Context: Floor Play Observer:Date: Time: Social Context: Teacher brings him to the floor, sits him down, and then leaves. Behavior Problem: Pulls shirt off one arm, hits head with fist, thrusts back, head bangs. Social Reaction: Teacher returns, helps him with getting shirt back on and then hugs him. POSSIBLE FUNCTION: Adult attention 49

50. Setting Event Data Collection 50

52. 52

53. Activity Analysis Child: Rachel Routine/Activity: House Center Activity DescriptionBehavior ExpectationsProblems Steps: 1. Select materials 2. Pretend in roles 3. Exchange materials with peers 4. Follow peers’ lead or accept role assignment 5. Clean-up 1. Pick materials that no one is using 2. Use materials appropriately 3. Don’t take from peer 4. Maintain engagement 5. Put materials on shelf in correct area 3. Takes materials from others 4. Ignores peers, interferes in play 53

54. Activity Analysis Child: Rachel Routine/Activity: Snack Activity DescriptionBehavior ExpectationsProblems Steps: 1. Sit in chair 2. Take food from plate when passed 3. Eat food on plate 4. Drink juice from own cup 5. Ask for more food 6. Wipe face with napkin 7. Throw plate/cup/napkin away when finished 1. Stay in seat 2. Take one item, wait for turn 3. Eat from own plate 4. Drink and put cup on table 5. Ask if using please 6. Use napkin, not clothing 7. Clear place, throw in trash 2. Takes multiple items, puts hand in bowl, grabs while plate is passed 3. Takes food from other children’s plates 5. Grabs food when she wants more 54

55. Everybody Helps Family collects data Collect data in ALL settings 55

56. “KIS” “KIS it” (Keep It Simple) Create simple, user-friendly forms to collect information (e.g., rating scales, check sheets) 56

57. Home Observation Card This card can be used by families when doing observations 57

58. Functional Assessment Interview Define behavior (describe what you see) Describe frequency and intensity Explore possible setting events Identify predictors Identify maintaining consequences Identify current communicative functions Describe efficiency of the behavior Describe previous efforts Identify possible reinforcers 58

59. Functional Assessment Interview Refer to sample of Jackson’s Functional Assessment Interview in handouts. 59

60. Working as a Collaborative Team Assign roles Determine agenda and time for meetings Ensure group participation through facilitation and participatory processes 60

61. Roles Facilitator – person who guides group in stating agenda, work goals, time allocation Recorder – person who writes down the discussion Time Keeper – person who tracks time and warns when agenda item is ending Reporter – person who shares group information, makes presentation Encourager – person who provides feedback to group members Jargon-buster – person who asks the question “what do you mean when you say ‘gobbley-gook’” and helps the group with communicating clearly 61

62. Determining the Function of Challenging Behavior Assign roles Review child description Review observations Review interview Complete final page of interview Determine functions of problem behavior Report to group 62

63. Process of Positive Behavior Support Step 1: Establishing a team and identifying goals of intervention Step 2: Gathering information (functional assessment) Step 3: Developing hypotheses Step 4: Designing behavior support plans Step 5: Implementing, monitoring, and evaluating outcomes 63

64. Hypothesis Statement Description of the challenging behavior Predictors of the challenging behavior Purpose of the behavior Maintaining consequences 64

65. Hypothesis Statement Jackson avoids the demands of activities that he finds difficult (structured language- based activities, sharing objects, interactive play) by resisting or withdrawing. If pushed to participate, Jackson will react by throwing objects, screaming, or stating “shut up.” When he resists, adults will often give up or allow him to leave the activity. 65

66. Hypothesis Statement Billy will use tantrums to request a social interaction. Billy will initiate a chase game or request to be held by pulling the adult’s hand or positioning the adult. If the adult does not comply, Billy will cry loudly, scream, and bring his hands to his face or ears. Often the caregiver will comply with his request or pick him up. 66

67. Hypothesis Statement Marcia tantrums to escape moving to a new activity. When she is asked to transition from an activity (e.g., playing in the sandbox) to another activity, she will whine, cry, pretend to vomit, slap at the adult, and scream. When she does this, the adult lets her stay a little longer with the original activity or picks her up kicking and screaming. 67

68. Hypothesis Development Assign roles Review functions as determined by your case study group Write hypothesis statement on overhead or chart paper Present to group 68

69. Not Sure about the Hypothesis? What would make the challenging behavior stop? Is it something you would provide or allow the child access to? Or is it something to remove or allow the child to leave? If still unsure, collect more data in the same context Some challenging behaviors may have the same form, but serve multiple functions Some problem behaviors may begin around one function (e.g., escape) and continue to access something additional (e.g., attention) 69

70. Summary Challenging behavior has meaning for the child The function of challenging behavior is defined by the context Functional assessment is the formal process for determining the why (i.e., function) of challenging behavior 70