1. PBIS in the Home for Students and Adults with Disabilities Kelly Jewell, PhC kjewel2uw@gmail.com

2.  Case Study Background  Triangle in the Home  Putting together the Team  Team Responsibilities  Developing Behavior Matrix (Expectations)  Teaching and Monitoring Expectations  Developing and Reinforcing Expectations  Consequences  Tier 2 and Tier 3  Things to Consider ***Feel free to ask questions along the way Agenda

3. Background Information  Adult with cognitive disabilities  Deaf  Struggles with physical activity  Health issues requiring constant companionship  Parent’s goal for independent living  Adult struggles with learned helplessness and violent behaviors (hitting, scratching, biting, and kicking)

4. Triangle at School verse Home With All Students: Universal With Some Students: Secondary With Few Students: Tertiary Always with Person: Universal Sometimes with Person: Secondary Rarely with Person: Tertiary

5. Team Members  Adult or Student (Individual)  Parent’s  Mom and Dad  Roommate or Siblings  Carestaff: People who work with student or adult  Adult or Student’s friends  Family members and friends of Parents  Former Carestaff  Job Coach/Trainers  Community Members

6. Universal Team’s Responsibilities  Follow similar philosophy of PBIS Leadership teams in schools  Develop expectations together and from previous data  Post, teach, review, monitor, and reinforce expectations  Culturally appropriate  Participate in Quarterly meetings with Carestaff or direct connections  Participate in Yearly meetings as a team

7. Developing Behavior Matrix  Team’s current concerns and Previous, Documented Behavior Problems  Carestaff Notes  Individual’s Behavior Concerns  Parent’s Behavior Concerns  Positive Language on what individual should be doing  Developed Behavior Matrix for Carestaff  Schedule and Responsibilities  Post: Notebook within the house, discrete

8. Behavior Matrix

9. Teaching and Monitoring Behaviors  Prior training of all Carestaff, directly involved individuals, and parents  Individual training through multiple methods  Discussion  Modeling – Demonstrate  Video  Picture  Review only specific expectations after documented event Monitor: Carestaff Notebook and Individual email

10. Carestaff Notebook

11. Developing Reinforcement  Adult or developmentally appropriate  Monitor/track for obsession  Universal understand of appropriate reinforcement  Consider short and long term goals  Specific behaviors  Stay focused on matrix  Part of normal life routine, like being an individual, adult

12. Reinforcement  Extra times out to eat  Movies/dvd’s  Girl trips  Day off of work  Special time with friends  Shopping

13. Whens things are not going well  Not demonstrating behaviors on matrix  Direct refusal of a chore or task  Dishes  Taking time getting ready for non-preferred activity  Being late for work  Inappropriate, constant talk about others  Aggression toward others

14. Consequences Level 1 Reminder of expectations Ignoring inappropriate behavior Review of matrix Level 2 Discussion with behavior specialist or mom and dad Reminder of expectations and consequences for not following expectations Review of matrix Level 3 Loss of preferred activity Pay for damage (dishes) Discussion with behavior specialist, mom and dad, and Carestaff ***Keep consequences natural and individual choice.

15. Sometimes (Tier 2)  Individual needs specific support with expectation  Check In/Check Out (Self-Monitoring) Chart  Reviewed expectations prior to starting task  Individual monitors expectations through task  Check mark for completing guideline  Review expectations after finishing task  Receive praise and potentially preferred activity (after multiple correct completions of expectations)  Observed by Carestaff

16. Rarely (Tier 3) Wrapping person with support  Multiple trainings with Behavior Specialist  Group meeting with mom, dad, behavior specialist and Carestaff  Loss of multiple preferred activities to support in refocusing  Regain preferred activity with demonstrate of appropriate behaviors  Additional supports with chore/task activities  Emergency visit with therapist

17. Things To Consider  Family Emotions  Research and Practice  Individualized triangle  Making sure everyone is trained on expectations and wording  What to do when someone is absent or missing

18. Questions Comments