Addressing Challenging Behavior: Fu nctional Behavior Assessment and Positive Behavior Supports

Addressing Challenging Behavior: Functional Behavior Assessment and Positive Behavior Supports

Challenging Behavior

Behavior that results “…in self-injury or injury of others, causes damage to the physical environment, interferes with the acquisition of new skills, and/or socially isolates the learner”

( Doss and Reichle )

Challenging Behavior in Children with Down syndrome

– Coe et al., (1990) and Dykens and Kasari (1997) found higher rates than typically developing children of:

• attention deficits• social withdrawal• noncompliance

– Compulsive like behaviors (e.g., arranging objects, repeating certain actions) (Evans & Gray, 2000)

– Talking to themselves (Glenn & Cunningham, 2000) – Problem behaviors associated with anxiety, depression, and

withdrawal increase with age (Dykens & Kasari, 1997; Einfeld, Tonge, Turner, Parmenter, & Smith, 1999).

Functional Behavior Assessment (FBA)

An FBA is designed to assess the causes of a student’s challenging behavior and to make recommendations on corresponding reports and subsequent behavioral intervention plans.

What do we do?

– A systematic method of assessment for obtaining information about the function of a problem behavior

– Identifies the variables that appear to lead to and maintain the behavior – function

– Used to help make a plan to increase appropriate behavior and decrease inappropriate behavior

5 Steps for Conducting an FBA

1. Identify challenging behavior in concrete and observable terms2. Collect information utilizing indirect assessments. 3. Utilize direct measures to collect data on the challenging behavior and

establish base-line levels. 4. Analyze data collected.5. Develop a hypothesis that describes why the behavior is occurring.

NOTE: Once the FBA is complete Develop recommendations and/or create a BIP to improve the

problem behavior. Implementation of a BIP. Evaluate the plan and modify as needed.

Step One

Identify challenging behavior in concrete and observable terms.

What constitutes problem behavior?What constitutes problem behavior?

May interfere with the student’s ability to learn (or the learning of others)

May be dangerous to a learner

May be dangerous to others

May place property at risk

May create a barrier to participation

May create a barrier to relationships

May be stigmatizing

Define the Problem in Observable and Measurable Terms

Must be observable, measurable, precise and not subject to interpretation

– What does the behavior look like (topography)– When does the behavior occur– Where does the behavior occur– With whom does the behavior occur– How often does the behavior occur

Identify Challenging Behavior in Concrete & Observable Terms

General descriptions

Concrete & Observable Descriptions

Student is aggressive

During lunch, when student doesn’t get his way, he hits other children

Student is disruptive

Student continuously calls out and makes inappropriate comments during math seat work

Student is hyperactive

Student continuously moves around on seat, plays with items on desk, and gets out of his seat w/o permission during reading activities 10

STEP TWO

Collect information utilizing indirect assessments

Indirect Assessment

Questions To Be Answered

1. What are the antecedents of the challenging behavior (e.g., setting events that elicit the behavior)?

2. What are the consequences for the challenging behavior, which may reinforce it?

3. What does the student gain?4. What does the student avoid?

STEP THREE

Utilize direct measures to collect data on the challenging behavior and establish base-

line levels.

Direct Measurement

• ABC Chart - Antecedent Behavior Consequence data ABC Chart

ABC Data

Direct Measures• Direct Measures

– Frequency– Duration– Latency– Intensity

• Scatter Plot - data during specific time intervals across the day

Scatter Plots

Questions to be answered…

• What is the intensity of the challenging behavior (e.g., frequency, duration, strength, etc.)?

• How does student’s challenging behavior compare to his or her peers?

• How does the student’s challenging behavior vary across settings?

STEP FOUR

Analyze data collected

Questions to be answered. . .

• What patterns of antecedent events and/or consequences are connected to the student’s challenging behavior?

• What is the student gaining or avoiding?• What are the antecedent events that elicit the behavior and

what are the consequences that reinforce the behavior (A-B-C’s)?

• Do skills and/or performance deficits contribute to the challenging behavior?

• Are setting events contributing to the behavior?

Functional Analysis

• Consists of the systematic manipulation of controlling variables to demonstrate the function of the behavior (O’Neill et al., 1997 as well as Iwata, Dorsey, Slifer, Bauman, & Richman, 1982).

• Functional analysis involves measuring rates of challenging behavior as a series of conditions are introduced.

Conduct Functional Analysis

• Manipulate different environmental events to see how behavior changes

• 4 specific conditions are evaluated

• Alone – test for automatic reinforcement

• Attention – test for socially mediated positive reinforcement

• Demand – test for socially mediated negative reinforcement

• Play – control for the three other test conditions

Examples of manipulations

– For a period of time do not deliver any attention while measuring behavior

– Then deliver high rates of high quality attention while measuring behavior

•Task Avoidance– Deliver easy then hard tasks, novel versus

maintenance items•Non-socially motivated

– Place the child in a variety of situations and observe the behavior

STEP FIVE

Develop a hypotheses that describes why the behavior is occurring

Why do students display problem behaviors?

• Five Primary Functions:

SEATS

S: Setting Events

Biological/Physiological EventsSleeping, eating/diet, medication, toileting, health, presence of a specific disability

Environmental EventsPhysical events: e.g., temperature, noise, architecture Social events: e.g., staffing changes, previously occurring social interactions characterized by positive or negative valence), forgot favorite toy, number of people in room, changes in schedule

Specific Syndromes asa Setting Event

• McGee (1999) noted that the presence of a specific disability itself may in fact function as a motivating operation. – a decrease in the reinforcing value of attention in

individuals with autism– an increase in the reinforcing value of food in

individuals with Prader-Willi.

Down Syndrome as aSetting Event

• Wishart (1987) demonstrated children with Down syndrome have a tendency, even at an early age to engage in escape behavior

– Demonstrated children with Down syndrome have a propensity to engage in noncompliant behavior often taking the form of “cute” party tricks.

– Observed such behaviors during assessment tasks, particularly when the children were presented with slightly more difficult tasks.

– Thus, specifically in children with Down syndrome, there may be an increase in the reinforcing value of escaping demands and possibly an increase in the reinforcing value of attention.

E: Escape

Learners may display problem behavior in order to escape from, delay, or avoid, tasks and activities

Examples: work demands, chores, transitions to non-

preferred activities, etc.

A: Attention

Learners may display problem behavior in order to gain attention from adults or other students

Examples: parent/teacher attention, peer attention,

reprimands, praise, etc.

T: Tangible (Toys/Things)

Learners may display problem behavior in order to access preferred items

Examples: Preferred activities, toys, books, snacks, etc.

S: Sensory

• Learners may display problem behavior in order to access to or avoid sensory stimulation

Formulate a Written Positive Behavior Support Plan

• Rationale• Target Behaviors

– Behaviors to increase– Behaviors to decrease

• Hypothesized function of behavior• Antecedent Strategies• Reactive Strategies• Measurement• Implementation• Follow up

Target Behaviors

Include all behaviors to be addressed– Behaviors to increase– Behaviors to decrease

Must be operationally defined

Hypothesized Function of Behavior

• What is the hypothesized function?• How did you determine the function?

– MAS/FAST– ABC Data– Functional Analysis

Is Behavior due to Setting Events

• Biological – illness, lack of sleep, ear infection, menses, fatigue, allergies

• Environmental – noisy and/or crowded environment, negative interaction

Setting Event Checklist

• If you believe there is a relationship between setting events and challenging behavior:– List the setting events that are likely to affect challenging

behavior– Create a system where a caregiver identifies if a setting

event occurred on a give day– Refer to suggestions to address setting events to help to

decrease the likelihood of challenging behavior

Setting Event Checklist

Event 4/1 4/2 4/3 4/4 4/5 4/6

Didn’t get a good night’s sleep

Mom out of town

Allergies acting up

Can also report via telephone, fax, e-mail, text

Addressing Setting Events• Remove the setting event (e.g., ensure good

night sleep, medication is taken)• Neutralize the effect of the setting event (e.g.,

relaxation routine, provide food or medication, allow for a nap)

• Remove stimuli that occasion problem behavior when setting event present (e.g., change in schedule, reduce demands)

• Increased the rewards available for appropriate behavior when setting event present

Antecedent Strategies

Environmental changes that will decrease the likelihood of the target behavior occurring


• What can you do to set up the situation so problem behavior is less likely to occur?

• What can you do to set up the situation so appropriate behavior is more likely to occur?


General• Structured teaching environment• Clear and consistent expectations• Schedules and visual strategies• Alternate work and play activities• Intersperse active and quiet activities• Transitions should be short and organized• Catch the student being good• Know the triggers of the student’s behavior• Embed reinforcers

Offering Choices

Provide Choice of 2 options– may need visual cues– may need 2 preferences– shift to 2 non preferred

Examples– Would you like to play blocks or look at books?– Would you like your drink or snack first?– Would you like to pick up red blocks or blue blocks?

Offering Choices

Choices can be offered on where to do a task, when, with which materials, how, and with whom

Generally, forced choices (e.g.., “You can have the red or blue pencil”) produce more compliant behavior than “yes/no” choices (e.g.., “Do you want to get your pencil?”)

Preferred Item as a Distracter

Allow the child to engage in the activity using preferred materials

MarkersColored pencilsLaptopOverhead projectorColored paper

High Probability Requests• Identify high probability tasks• Identify low probability task• Request 2-3 high probability tasks followed by a low probability

task• REINFORCE• Utilize a fast pace of instruction

High Probability Requests

• Gain compliance on some high probability requests (mastered, easy, preferred tasks)

• Quickly ask for compliance on low probability request (new, harder, less-preferred)

• Variation: “Slam-the-door” technique

Pre-Specify Reinforcer

• Describe the reinforcer prior to making a request– “I can’t wait to go shopping this afternoon, first

let’s stop in the dry cleaner.”– “Lunch in the park is going to be so much fun!

We’ll go as soon as we go to the post office.”– “I have your favorite snack. Quick, let the doctor

check your throat.”

Collaboration

• Fill in some of the answers so that the child will have same sheet but not required to complete them all

• Provide child with opportunity to circle/highlight items that you will complete– Can build a “tolerance”, starting off with several

and then less and less over time


• Visual Schedules/First/Then• Token Systems/Classroom Management• Reminders and Rules• Count Down/Count Up• Social Stories• Power Cards

Visual Schedules

Step by step visual guide to completing tasks independently

List of activities that need to be completed in sequence

The visual pictures cue the person to perform each task in the sequence of activities.

Visual SchedulesSchedules need to be portable and easy to

access and use. Schedules should not be faded out as the

student “learns” their schedule. Pictures, words, colored-coded cards can be

used.

Visual Schedules

Can be used to represent a full dayCan be used for a partial day (morning than

afternoon)Can be indicated as a first___, then ____

Visual Supports

Activity SchedulesAn activity schedule is a set of pictures or words that

cue a child to follow a sequence of activities.When mastered, the schedule helps children to be

more self directed and purposeful in home, school, and leisure activities.

With this visual cueing system, students move the picture of each task to the done envelope as it is completed.

Reinforcement Systems

Token Systems

• Reward Systems

▫ Student to earn “tokens” (any tangible object) that can be “cashed in” for a highly preferred activity/reinforcer

▫ Tokens earned based on identified target behaviors▫ Tokens can take many forms, Numbers, checks, words; Cartoon

characters; Puzzle pieces▫ ALSO serve as reminder of rules

Advantages of Token Economies• Immediate, unobtrusive delivery of reinforcers• Allows for delay of reinforcement• More and more frequent reinforcement can be delivered

and for a longer time• Ease of generalization• Greater individuality of reinforcement• Structures administrators attention and reduces

subjectivity• Allows for differential valuing of performance

Examples of Token Systems

Token Boards (Individual)TalliesTicketsPoints

Reminders and Rules

Visuals can be used to reinforce or remind students of

rules.Sit niceHands downQuiet mouthClose bathroom doorClean up

Contingent Reinforcement Procedures

• Important for parents/family members to be prepared to respond when the learner engages in appropriate behaviors.

• Important for parents/family members to know how to respond if the challenging behavior does occur.

Noncontingent Reinforcement

(Cooper et al., 2007)

Noncontingent Reinforcement

Differential Reinforcement

Simply stated:– Systematically reinforcing one

response while simultaneously withholding reinforcement for another

Differential Reinforcement

• Differential Reinforcement of the Omission of the Behavior (DRO) = reinforcement is delivered when the child does not engage in the challenging behavior for a pre-specified period of time

• Differential Reinforcement of Alternative Behaviors (DRA) = reinforcement of behaviors that serve as alternatives to the difficult behavior (e.g., communicative alternative)– Communicative Replacements– Work behavior– Appropriate social behaviors

Differential Reinforcement (cont.)

• Differential Reinforcement of higher rates of behavior (DRH)= previous performance is monitored and then current performance is compared. If higher rates of behavior occur, reinforcement is delivered.

• Differential Reinforcement of lower rates of Behavior (DRL) = previous performance is monitored and then current performance is compared. If lower rates of behavior occur, reinforcement is delivered.

Antecedent Strategies based on Function of the Behavior

Escape/Avoidance• Enrich the task environment• Use an alternative mode of task presentation• Pair demand with a reinforcer• Teach an alternative communication response

– FCT• Use behavioral momentum

– High probability request sequence• Increased breaks

– Releasing from circle time or manipulative activities early


Attention

• Determine how frequently the learner gets attention for problem behavior (e.g., once every 10 minutes)

• Deliver attention to learner (in the absence of problem behavior) at a faster rate (e.g., every 8 minutes)

• Do not deliver attention for problem behavior


Tangibles• Giving increased access to favorite foods, toys,

clothing

– Increased access to preferred activities • Computers • Playing outside• Games• Magazines, books• Coloring• Video games


Sensory• Increased or decreased sensory input

– Increased Sensory Input • Jumping on a trampoline• Rolling on mats• Bouncing on a yoga ball

• Decreased Sensory Input• Remove from large groups• Remove from noisy areas

*** Must be done Antecedently only!! ***

Replacement Behavior

Teach a more appropriate behavior that serves the same function as the target behavior and is more efficient


Tolerance for Delay• An intervention developed to help children maintain

participation in an undesirable activity for increasing lengths of time

• Waiting for a desirable activity for increasing lengths of time


Communication • Build a functional language repertoire• Which of the following are functional language skills?

– Knowing the capitals and 50 states– Identifying all the colors– Counting to 100 by 10s– Requesting a drink– Rejecting a social offer– Choosing what to eat for lunch– Asking to take a break


Functional Communication Training• Identify a new, alternative response that serves the same

function as the problem behavior

• The alternative response should result in greater reinforcement and more effective interaction with the environment


Examples of Replacement Behaviors (cont.)

Functional Communication Training• How to implement FCT

• Decide what alternative response you want to teach the learner to use instead of the problem behavior

• Determine when you will use the intervention• Teach the learner to use the alternative response form by

using prompts, and reinforcing each occurrence of the desired behavior

– Alternative response should require minimal response effort and access reinforcement across all environments

Discussion

Problem Behavior Replacement

Gagging = Drink Picture of a cup = Drink

Biting = “I need a break”” ____________ = “I need a break”

Spitting= “I want to play” ____________ = “I want to play”

Screaming = “It is too loud” ___________ = “It is too loud”


Reinforcement Systems

• Token System

– Sticker charts– Penny boards– Count up Count down

• Token Economy– Money

• DRO/DRA

Delivering Reinforcement

Rule 1: Cannot tell whether something is a reinforcer until try it and observe effect on the behavior.

Rule 2: What is a reinforce for one person may not be for another. Individualized.

Rule 3: To be effective, a reinforce must occur during or immediately after the behavior.

Delivering Reinforcement

Rule 4: Limited AccessRule 5: Reinforcement must be contingent if it is to be

effective. RE: First this, then that.Rule 6: When strengthening a new behavior, reinforce

frequently.Rule 7: Size of SR+ is big enough to keep student

motivated, but not to big for satiation

Reactive Strategies

Must follow ethical guidelines for behavior reduction

Fair Pair Rule

Least restrictive procedures

Preserve safety

Preserve dignity

Reactive Strategies

Extinction• Breaking a contingency between a response and a reinforcer

• Typically involves withholding the reinforcer contingent on the behavior targeted for reduction

• Extinction bursts are predictable and common and include:– increase in rate/intensity of responding

• If the behavior is reinforced during extinction it will re-occur at the greater rate and intensity

• Everyone must consistently implement the extinction protocol

Reactive Strategies

Extinction• Protocol must be maintained for a sufficient time• Desired behaviors may inadvertently be extinguished by failing

to provide adequate reinforcement• The learner must be kept safe without providing reinforcement• Respond without emotional reaction• Extinction induced aggression and spontaneous recovery are

possible• Reinforcement procedures should always be run with an

extinction procedure

Reactive Strategies based on the Function of the Behavior

Attention• Do not use the learner’s name

• No eye contact

• No yelling

• No lectures

• Limited “chasing”


Escape/Avoidance

• Learner is not allowed to elope from circle time

• Learner must complete presented task– Finish a puzzle– Complete a discrete trial – Clean up

• Learner must stay in the classroom


Tangible• Learner cannot access the item or activity that evoked the

problem behavior

– Learner may not have the lollipop they asked mom for

– Learner may not access materials on a high shelf that they climbed up to get

– Learner may not watch TV after pushing someone out of the way in order to access the remote


Sensory• Change the environment

– Remove items learner uses in a self stimulatory / inappropriate manner

• Block the behavior

• Move the learner to another area– e.g., move to the learner to a room without fluorescent light

Reactive Strategies

NYSED Requirements Relating to the Use of Behavioral Interventions and Supports

• Prohibit the use of corporal punishment

• Prohibit the use of aversive interventions, with limited exceptions

• Authorize the limited use of unlocked time out rooms where a student is observed by staff at all times when a student needs an area to safely deescalate, regain control and prepare to meet expectations to return to his or her education program

Reactive Strategies

NYSED Requirements Relating to the Use of Behavioral Interventions and Supports

• Authorize the use of reasonable physical force, including the use of physical restraints only in emergency situations in which alternative procedures and methods not involving the use of physical force cannot reasonably be employed

The State Education Department The University of the State of New York

Punishment

Prior to implementing any punishment procedures, there must be data documenting

attempts at behavior change using less intrusive procedures.

The determination to use punishment procedures should be made by an

intervention team involving input from parents.

Reactive Strategies

Punishment ProceduresPositive Punishment

– Decreases the future likelihood of a behavior occurring by adding an aversive stimulus to the environment

Reactive Strategies

Punishment ProceduresNegative Punishment

– Decreases the future likelihood of a behavior occurring by removing a reinforcing stimulus from the environment

• Time out• Response Cost

(i.e. late fees, traffic tickets, loss of tokens)

• Removing a preferred activity(i.e.TV, Dessert, Play time, Play date)

Reactive Strategies

Punishment Procedures Negative Punishment

Recommendations for time out from reinforcement

Should not exceed one minute per year of age Use of bathroom and drink must not be withheld Do not time out from an aversive event Child should be monitored (no attention) Release is contingent on absence of targeted problem

behavior or pre-selected criteria Document occurence and length of time out

Reactive Strategies

Punishment Procedures • Disadvantages

– Punishment induced aggression may occur– Can produce other side effects – Avoidance behaviors– Spontaneous Recovery is possible– Behavior may return with increased duration, frequency and

intensity – May be imitated by peers– Can cause people and settings to become conditioned punishers– Does not teach any new behavior– May cause learner to model our behavior– Professionals may opt to use this method and disregard using

reinforcement procedures

Implementation

• Clearly define how the plan will be implemented• Indicate specific steps• Identify who is responsible for implementing the plan• Identify necessary materials and data collection methods

Measurement

• How will the behavior be measured (What kind of data ?)

• Who will be taking the data?• How often will data be collected?• Who will analyze the data?• How often will the data be analyzed?• What is the criteria to determine the plan’s effectiveness?• Criteria for mastery

Follow Up

• Ongoing communication regarding behavior plan

• Date to be reviewed

FAQ’s

• What should I do if the BIP works for a while, and then the problem behavior comes back?

• What if the BIP works in some situations and not others?

• What if a parent or teacher will not follow through with the BIP?

Functional Behavior Assessment Checklist

Identify behavior to be changed

Operationally define target behavior

Conduct Functional Analysis

Conduct an unstructured observation

Conduct a structured observation - record data (ABC, scatter plot)

Analyze data for patterns

Determine function and develop hypothesis

Formulate a Behavior Intervention Plan (BIP)

Thank you!

Documents

Addressing Challenging Behavior: Fu nctional Behavior Assessment and Positive Behavior Supports