Transcript Nonverbal Intelligence and Speed of Responding in Children

Creating a Roadmap to Success
Best Practice Interventions for
Challenging Behavior at Home and School
Jane Barbin, PhD, BCBA-D, LBA
[email protected]
www.BehavioralDirections.com
Overview

Why do kids misbehave (or behave) –
strongly related to what is reinforced!

Inappropriate behavior serves a purpose

Environmental events influence behavior
(antecedents / consequences)
Overview

Functional assessment seeks to answer the
question “Why does he/she do that?”

Looking at~
 what antecedents occasion behavior
 what consequences maintain behavior
Overview

Interventions based on the function of the behavior
have been shown to be more effective and less
likely to involve punishment.

The goal is to replace the function of the
inappropriate behavior.

Behaviors that look identical can be maintained by
totally different functions (for different reasons)
Why important to address?

Caregivers (e.g., parents/educators) can effect
significant change in the natural environment

They interfere with skill acquisition

Stigmatizing to individual

They reduce available opportunities (e.g., vocational,
recreational) and limit generalization

Harmful
Interfering Behaviors
Topography (Form) –
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Ritualistic / perseverative behavior (stereotypy)
Tantrums (yelling, dropping, profanity)
Aggression
Disruption (grabbing /breaking items)
Self-Injurious Behavior (SIB)
Noncooperation
Wandering
Interfering Behaviors
Function (Reason) 
Escape / Avoid

Attention (divided attention)

Access to Preferred Items / Activities
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Automatic (behavior reinforces itself)

Other (i.e., conditioned fears, control function)
Developmental Stages

Behavioral challenges (and opportunities!) present at
various stages, affecting behavior (Terrible 2s,
adolescents, new siblings, sibling with special needs).

Normal part of child’s challenging their environment.

How this is handled by parent and other adults can be
critical!
What is Functional Assessment?

A continuum of assessment procedures from
indirect methods to experimental methods

Includes several techniques to identify the
reason the behavior is occurring. Consider
maintaining factors and motivating operations
(e.g., illness, academic deficits establish
escape).
Methods
A. Informant Assessment (indirect) – questionnaires,
rating scales, interviews. Nothing manipulated. Use
multiple informants!

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Motivation Assessment Schedule (Durand & Crimmins,
1988),
Questions About Behavioral Function (Matson & Vollmer,
1995)
Functional Analysis Screening Tool (Florida Ctr. on SelfInjury, 2002)
School questionnaires may not have established
psychometric properties.
Methods
B. Descriptive Assessment (direct) –

Antecedent-Behavior-Consequence (ABC) assessment
(structured ABC)
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Scatter plot
More reliable than above but still anecdotal. Observe for
correlation between antecedents/consequences and behavior.
Nothing manipulated; hard to get reliable and valid results
Methods
C. Functional Analysis ~ used < 17% of time

Direct observation / Experimental ~most difficult & most accurate

Variables manipulated systematically (tests cause-effect)

Student put in specific conditions and information gathered on
problem behavior

Five conditions alternated in 5 or 10 minute sessions ~ analog and
natural setting

Difficult for low rate behaviors, time consuming, advanced training
needed
Functional Analysis Conditions

Attention - attention given to targeted behavior (“That’s
too loud.”, “ Don’t throw things.”). All else ignored. If
behavior occurs to gain attention, should see increase.

Tangible - access to preferred items/activities given for
targeted behaviors. No other attention. If behavior occurs
to gain access to these, should see increase.
Functional Analysis Conditions - cont.

Demand - demands are presented every 30 sec.
Escape from task given for 30 sec. if behavior occurs
(“Ok, you don’t have to do it.”). If behavior sensitive to
escape, should see increase.

Alone - evaluating automatic / intrinsic reinforcement.
No social consequences for behaviors

Toy Play - control condition. Noncontingent attention +
preferred items are provided. Targeted behaviors
ignored and redirected.
Functional Analysis -Self-Injurious Behavior
14.0
12.0
10.0
Rate Per Minute
Demand
8.0
Alone
6.0
Toy
Play
4.0
Attention
2.0
0.0
2 4 6
8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66
Sessions
What Technique is Best?

1997 IDEA amendments mandate FA, no guidelines

Reliability & validity of method; always conduct interview
(e.g., operational definitions, idiosyncratic variables)

Educational setting requires efficient FA, minimal training &
accommodation to schedule demands

Behavior analysis field provides structured observations,
brief functional analysis, better rating scales, structured
interview: Functional Analysis Interview (O’Neill et al., 1997)
Behavior Intervention Programming

Conduct functional assessment

Select function-based treatment

Explore acceptability and ability of caregivers to
implement (OBTAIN INFORMED CONSENT)

Provide adequate training and monitoring
A Helpful Place to Start 
What constitutes the behavior (OPERATIONAL
DEFINITIONS) for consistency across adults?

Reinforce “good” behavior quickly and often.
Don’t only look for poor behavior.
More Ideas to Start ~

Catch the child being good!
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Be careful not to accidentally reinforce maladaptive
behavior.

Caregivers must agree on goals and commit to a
plan. You are a model for your child.
More Ideas to Start 
Provide clear direction ~
 avoid repeating
 close proximity
 use child’s name
 get eye contact
 use firm, neutral voice
 provide clear and simple language
Why is this difficult to do?

Adults may feel:
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Guilty about setting limits
Encumbered by spouse
Low energy
Difficulty confronting child and/or being the bad guy (e.g.,
hearing “I hate you.”)
Hopeless / lack skills
Other interfering situations- marital problems, financial
concerns. Work toward correcting what is hindering
your BEST actions!

There is a whole body of research supporting
effectiveness of these procedures so be
encouraged!

Understandably, the work is hard and more
than you may have bargained for!
BIP Interventions
A.
Extinction

Discontinuing reinforcement for previously reinforced
behavior
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Used only if there is good control over reinforcement

Can entail ignoring the behavior, response interruption or
working through (depending on function)

Might see an Extinction Burst. Ensure that is it safe to
use extinction before starting (not always essential to see
behavior change).
BIP Interventions
B. Antecedent Modifications

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give choice
reduced demands (difficulty, amount of work)
provide more attention
reduce verbal prompts or environmental noise
non-contingent reinforcement
enriched environment (e.g., provide music/edibles/
choice)
“Sensory-Work-Reward” schedules
My Way- Your Way plan
BIP Interventions
C. Reinforcement-based Procedures

Teach Functionally Equivalent Alternative Behavior:
Teach child to request attention, break or item, teach
waiting, provide other forms of communication

Use Differential Reinforcement Procedures:
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DRO (Other)
DRA (Alternative)
DRI (Incompatible)
DRL (Low rates)
More on teaching alternatives…
Targeted for
Look for
replacements
where you can and
respond
differently to each
behavior
in the child!
Decrease
Targeted for
Increase
Grabbing from others
Sharing
Whining
Talking in neutral tone
Hitting
Requesting a break
Tantrums
Asking for help
Premack Principle (‘Grandma’s Rule’)

Require lower probability behavior (unpleasant tasks)
contingent on higher probability ones (pleasant ones) “Do chores, then watch television.”
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Creates natural motivation
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Be fair when implementing. Consistency helps child
predict routines
Behavioral Contracts
Parent – Child Contract
I, Joey_, agree to: _do homework after school for 30 min.
before dinner Monday, Tues, Wed, and Thursday.
Mom and dad, agree to: give me 75 cents allowance for each
day it is completed.
Date Contract begins: March 10, 2015
Date Contract ends: End of Quarter 3 (then discuss)
Agreed by: ________________
________________
Parent(s)
Child
Reinforcer Options
Special outing/meal with parent
Game with parent
Yo-yo
Stay up late
Playing ball
Ice cream
Computer game
Certain video, iPad
Points that convert to allowance
High 5s
Picking dinner location/
Order pizza
Clapping
Homework pass
Verbal praise “good job”
Book
Smiles
Prize box
Break from work
Trip to favorite store
Time playing Wii
CD/iPod
Visual /spinning or blinking toys
Activation/sound toys
Trip to park
Singing
Play date with favorite friend
BIP Interventions
D. Punishment-based Procedures

These should not be utilized as a first plan of action
(less intrusive procedures must have been tried!)
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Punishment has been associated with negative sideeffects (e.g., punishment induced aggression, lack of
generalization to other settings)
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Support Rooms: look for lost opportunity to learn
adaptive skills, restrictive procedures?
Time-Out
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What is it?

How is it misapplied? (takes too long, location not boring,
discussion during and after with child, threats)
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When should it be used? (think “attention/tangible” function;
‘time out’ an item; planned ignoring)
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How used? (one min. per age, exit criteria, timer)
(Excerpt from SOS! Help for Parents book)
Interventions Based on Function
Escape
 Demand fading, request break/help, scheduled breaks, 3step guided compliance /follow-through, reinforce compliance,
outline task list
Attention / Tangible
 Teach to request attention or item (low effort), give scheduled
attention/ item, reinforce absence of behavior, social
reinforcers, planned ignoring, use of time out
Automatic
 Modify antecedents, blocking, provide alternative (competing)
stimulation, reinforce nonoccurrence (is it automatic?)
Escape Related Ideas
Escape Related Ideas
Escape Related Ideas
Outings/Trips
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Have a preset plan – reduce what is stigmatizing
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Anticipate snags
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Get other adults on board
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Transport your plan if one is working – adjust
accordingly
Supports Outside of Home
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Procedures can be difficult to carry out in
community (library, grocery store, museums,
vacation)
Prepare (preview online/ call in advance)
 Involve personnel
 Give staff/adults specific direction on ways
to help
 Reinforce support

My child’s behavior may be disturbing to you.
My child is not spoiled or misbehaving.
MY CHILD HAS AUTISM.
Over 2 million children are affected with Autism
in the US today. CDC reports 1 in 68 children have
Autism.
Families need your help and compassion.
Thank you for your support and being a friend to
someone with Autism.
(Please see other side for more information.)
My CHILD has AUTISM.
I am implementing a procedure that was
recommended by Behavioral Directions, LLC.
For more information you may contact
(703) 855-4032.
Camp Cheat Sheet
Sam has successfully used a Level Plan at home. There are 3 levels
(3=best privileges)
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If he stays on Level 3 at camp, he can earn “electronic time” during whole group
(mid-day) for 15 minutes and again after he is dismissed to his parent.
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He drops to Level 2 if he breaks any of the following rules: (1) Do your part/ Follow
Directions, (2) Kind words, and (3) Keep property safe. See specific definitions for
rules. If the Level 2 occurred before whole group, he skips the mid-day “electronic
time”.
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If he breaks the rule “Keep people safe”, he will drop to Level 1 (no electronic
access or dismissal privilege) for a 24 hour period. Inform parent.
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Avoid excessive negotiation or discussion with Sam on level drops /behavior.
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Sam should participate in the same system for earned items/activities related to
points as other campers. If he has a level drop at camp, only his 15 min extra
electronic access is lost.
Creating a “Positive” Environment
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Have fun with your child.
Communicate "I love you" often.
Have structure and routines.
Participate in family traditions and rituals.
Be a good listener.
Request feedback from your child and take turns talking.
Work on developing patience.
Build your child's self-esteem.
Help your child solve problems with peers.
(Adapted from Forehand & Long, 2002)
Potential Pitfalls:

Reciprocal escalation can occur when parents become
aggressive toward their child because the child
behaved aggressively.


This can worsen an already poor situation.
Complementary escalation occurs when parents give in
to the demands of a child. Rather than respond
appropriately to aggression, it is ignored to avoid
conflict.

Usually the more a parent caves in to the child's demands, the
more demands the child will make.
(Omer, 2001)
Data Collection- why?
Data Collection
For behaviors targeted for decrease or increase
include:
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Rate/frequency
Duration
Intensity
Latency
Percentage of whole or partial intervals
Percentage of opportunities
#1 Michelle: Difficulty Waiting in Community
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12 year old diagnosed with autism, ID and severe behavior
disorder
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Inpatient treatment for assessment and treatment of
challenging behaviors
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Difficulty waiting impeded outings (e.g., waiting in line or for
food, waiting in doctor’s office, waiting at signal in car)
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Functional Analysis -SIB, aggression, and heel dropping
were sensitive to escape
Michelle’s Community Waiting Plan
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Reinforce steps to target response + escape extinction +
competing items + wait card
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Locations chosen in conjunction with needs of family (e.g.,
frequent errands, shopping needs)
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First increased variety of known locations; then wait
interval /unknown locations
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Steps taken to minimize stigmatizing nature of program
Waiting Program Steps
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4 initial locations of importance (Target, CVS, Toys R Us,
Michael’s)
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Began with 30 sec. waiting period across stores (not at
front or for unpredictable times)
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Moved up time interval (to 4 minutes), Built in trying on
clothing, checking out, returns
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Pretested each step and randomized locations for each
data point (% correct opportunities). Data indicated
acquisition of all steps.
#2 Karey: Aggression, Disruption & Refusal
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16 year old diagnosed with autism
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Demonstrated challenging behavior at home and
school
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Attention, escape and access to tangibles
maintained behavior
Karey’s Behavior Plan: Reinforcing Low Rates of Behavior
(DRL) + Planned Ignoring + 3 Step Guided Compliance
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Day comprised of 1 hour intervals; 10 tokens
initially available / interval

Run by both parents across day
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Lost a token for each occurrence of targeted
behavior. Remaining tokens exchanged for
preferred items/activities. 2-3 “cash in” times /day.
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Family cued to increase attention (contingent and
noncontingent)
Behavior Reduction Program -Aggression
Baseline
DRL 10/hr + 3 Step Guided
Compl
3.00
DRL 9/hr + 3 Step GC + Loses next Sr +
DRA (attention) + 30 min T/O/Restitution
DRL 9/hr + 3 Step GC + Loses
next Sr (agg/dis)
Aggression - Rate Per Hour
2.50
2.00
1.50
Karey
1.00
DRL
9/hr
0.50
DRL
7/hr
DRL
5/hr
DRL 6/hr
0.00
1
5
9
13
17
21
25
29
33
37
41
45
49
53
57
61
65
69
Sessions
73
77
81
85
89
93
97
101 105 109 113 117 121 125 129
Tokens Remaining Per Interval - DRL
12
DRL
9/hr
10
Average Per Interval (hour)
DRL
7/hr
8
DRL
6/hr
DRL
5/hr
6
4
2
Karey
0
1
5
9
13
17
21
25
29
33
37
41
45
49
53
57
61
Sessions
65
69
73
77
81
85
89
93
97 101 105 109 113
Process - Behavior Intervention Programming
Observe and gather data on behaviors of concern
Functional assessment process to identify functional
reinforcers/ setting events
Develop function-based plan
Seek informed consent
Train relevant individuals – Implement!
Evaluate effectiveness with objective data collection
Make needed adjustments
Challenges

Difficulty demonstrating methodological control
(analyzing/controlling human behavior in applied
settings)

Confounding /other variables in environment (e.g.,
medication changes, parent away)
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Maintaining high integrity programs (protocol drift)

Limits to data-based decision making
Crisis Intervention vs. Behavior
Intervention Plan

Crisis: Procedures to provide for safety of
child and others in environment. Having a
plan and training adults reduces risk.

If crisis methods are used, a BIP should be
developed.

Procedures work hand in hand
Other Considerations

Component analyses can isolate effective treatment
elements (extinction, reinforcement). Do you need to
do all of the parts?

Explain Rationale / Reinforce Caregiver Compliance

Consider teaching appropriate skills as well as
reducing targeted behaviors for child

Plan early for successful integration and transitions
References
Cambridge Center for Behavioral Sciences (see Parenting under
“Behavioral Solutions” for great information and resources)
www.behavior.org.
Cannon, L. et al. (2011). Unstuck and on target!: An executive
function curriculum to improve flexibility for ASD. Baltimore,
MD: Brookes.
Clark, Lynn & Robb, J. (2005). SOS Help for Parents, 3rd Ed.
Bowling Green: Parents Press.
References cont.
Forehand, R. & Long, N. (2002). Parenting the strong-willed
child. New York: McGraw-Hill.
Latham, G. (1994). The Power of Positive Parenting. North
Logan, UT: P & T Ink. (www.parentingprescriptions.com)
Omer, H. (2001). Helping parents deal with children's acute
disciplinary problems without escalation: The principle of
nonviolent resistance. Family Processes, 40(1), 53-66.
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