1. Losing Control! 5 Point Scales
Alex Arfsten, BCaBA
Including Kids, Inc.
Humble, TX

2. Agenda What is a 5 point scale? Who are 5 point scales used for?
How are 5 point scales used?
What are the benefits of a 5 point scale?
Create a 5 point scale!
Coping Strategies
Progress monitoring
Additional activities

3. A tool to level behavior, feelings (covert behavior), or situations
What is a 5 point scale?
A tool to level behavior, feelings (covert behavior), or situations

4. What is a 5 point scale?

5. What is a 5 point scale? Voice volume Self-stimulatory behavior
Anger (behavior)
Relationship intensity
Level of funniness (of jokes)
Anxiety/fear (behavior)
Obsessions
Emergencies
Mistakes at work
Self-stimulatory behavior
Self-touching
Greetings
Perceived Control
Size of a problem
Assignment difficulty
Excitement
Word choice
Etc.

6. Who are 5 point scales for?
Clients, students, learners
Collaboration between: Parents/caregivers, Therapists, Teachers, Service providers, etc.
Consider:
Ability to differentiate colors or numbers
Target behavior has some escalation or different levels to it (Although you can use a scale to help 0-60 kids)
May need to initially adapt it to a 3 point scale when just starting out or if behavior doesn’t have 5 levels
May need more than 5 levels!

7. How are 5 point scales used?
Visual indicator of behavior intensity
Self-monitoring & teaching EF: emotional control
Clear consequences equated to behavior
Teach coping strategies
As a BIP to promote consistency
Teaching social expectations
As a way to track behavior

8. What are the benefits? It’s visual and portable!
Turn the subjective into objective—clear & concrete (& measureable!)
Proactive in expectations
Highly customizable
Teach learners to self-monitor
Gives learners language to communicate covert behavior
Can be used in groups or individually
Once learner understands the concept of a 5 point scale, you can use the system for anything

12. Articulation Scale

13. Test anxiety

16. Create!

17. Voice Scale Anxiety Scale Dating Scale Anger Scale
Step 1
Identify the behavior, feeling, situation for which your learner needs a 5 point scale
Voice Scale
Anxiety Scale
Dating Scale
Anger Scale

18. Step 2
Determine how many levels will be needed If you are starting with a 3 point scale but eventually want to make it a 5 point scale, use the numbers 1, 3, 5 (instead of 1, 2, 3)
Pro tip:

19. Using the leveled worksheet, label each level
Step 3
Using the leveled worksheet, label each level
Lost control
Stressed
Happy
Freaked out
Confused

20. Increased verbal stereotypy
Step 4
In the “Looks Like” column write the behaviors the learner engages in at each level (2-3 each)
hits
laughing
pacing
Increased verbal stereotypy

21. Step 5 Define those behaviors you’ve listed
Objective and measureable terms (operational definition)
So that anyone who will be using the scale with the learner will know when the behavior has occurred

22. Examples
Elopement: leaving the designated area by more than 3 feet without verbal permission from adult
Hitting: striking another person with hands/fist

23. Butterflies in stomach
Step 6
Optional step depending on the understanding and verbal level of the learner Have the learner describe how each level feels to them and include that in “Feels Like”
Butterflies in stomach
Heart racing
hot

24. Next Steps
Determine consequences, interventions and rewards at each level
Begin testing coping skills in real situations to determine effectiveness (take data)
Once you know (or suspect) which coping skills will be effective, put them in at each level (this can fluctuate and change over time)

25. Levels Level 1—happy Level 2—OK
Do nothing, this is a good place to be
Level 2—OK
Have strategies available but may not need
Level 3—starting to show signs of problem behavior
Present strategies
Level 4—escalating
Present & prompt strategies, limit verbal, may need change of environment
Level 5—lost control
Keep everyone safe, do not talk if possible

26. Also
If you are using the scale to teach social understanding and expectations remember
Teach directly outside of social situation
Review, if possible, right before the social situation occurs
Have out as a visual cue during social interaction initially
Refer to it during the social opportunity
Review the situation afterwards with the scale visual

28. Coping Strategies
Finding the most effective coping strategies is individualized for each person
Trial and error!
First practice them in role play and reinforce
Eventually MUST try them in the moment when the learner is escalated
Track effectiveness by collecting data
Duration of behavior
Amount of time it takes to go from escalated level to lower level
Verbal feedback from learner
Compliance with instruction/strategy

29. Coping Strategies Keep in mind Must be things the learner can do
Keep in mind a strategy that works at one level may not work at another level
Must be compliant with instruction to engage in the coping strategy
Will have to start with adult prompting learner to engage in the strategy
REINFORCE the use of the strategy

30. Help them get to their happy place.
Coping Strategy Ideas
…beyond “count to 10” and “take deep breaths…”
Do something nice for someone else
Ask for help
Use a “Brain Break” card
Use a “Come back to it later” card
List people/items you enjoy
Self-talk—repeat a helpful phrase
Fidget-Fidget Rule
Write in journal
Repetitive tasks
Fluidity
Be creative!
Help them get to their happy place.

31. Coping Strategies Also keep in mind
Coping strategies should de-escalate the learner yet not reinforce the occurrence of the behavior (this is tricky to tell sometimes)
The coping strategy should be available at all times, not just when escalated (might run into tangible function)
Make them visual!!!
A note on stress balls, fidgets, and compliance tasks….

33. To teach self-monitoring
Must have someone who can prompt learner to identify
Behavior engaging in
Reinforce accuracy
Level it equates to
Discuss any covert behavior (if needed)
Reinforce compliance
Prompt coping strategy
Reinforce compliance with strategy

34. To know if something is truly effective you must take data!!!
Progress Monitoring
To know if something is truly effective you must take data!!!

35. Show Me the Data!!
Track learner’s ability to identify triggers, level behavior and associate coping strategies in role play or scenarios
Have to be able to identify when you are escalating and know what to do or you won’t be able to self-monitor

38. Show Me the Data!!
Number of occurrences of each level at home over the week.
Highest level of excitement to gauge overstimulation

39. Show Me the Data!!
Tracking learner’s ability to self monitor in the moment and use of coping strategies (and help keep everyone accountable for providing reinforcement)

40. Additional Activities
Trigger sorting
When My Worries Get Too Big
Anxiety Curve
Behavior review

41. Trigger Sorting
Goal = ID triggers so strategies can be used proactively (and caregivers can be prepared)
Great idea to include triggers in school BIP with strategies

42. Anxiety Curve

43. Anxiety Curve 1 Foundation
pairing, positive relationships. Teach communication and coping skills to use in challenging situations 1

44. Anxiety Curve 2 Caregiver: Have tools ready Learner:
early signs of stress

45. Redirect, might remove learner from environment
Anxiety Curve
Caregiver:
Redirect, might remove learner from environment 3
Learner:
Use coping strategies

46. Anxiety Curve 4 Caregiver: Act, structure, use visuals, limit verbal
Learner:
May not be able to make choices

47. Safety first, calm and wait
Anxiety Curve 5
Learner:
Not rational, be safe
Caregiver:
Safety first, calm and wait

48. Anxiety Curve 4 Caregiver:
Limit verbal to praise, observe for signs of re-escalation 4
Learner:
Closer to crisis than calm

49. Supportive praise, possibly prompt calming strategies
Anxiety Curve
Caregiver:
Supportive praise, possibly prompt calming strategies
Learner:
Tired?
Embarrassed? 3

50. Might be the time to review (might not)
Anxiety Curve
Caregiver:
Might be the time to review (might not)
Learner:
Able to think clearer 2

51. Anxiety Curve
Caregiver:
Move on
Learner:
Move on 1

52. Behavior Review