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Monica Dowling, PhDDouglene Jackson, PhD, OTR/L, LMT
October 26, 2016
Engaging the Child withChallenging Behaviors
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My name is Monica Dowling. I will be speaking about managing challenging behaviors in children with neurodevelopmental disorders. I have no relevant financial interests or conflicts of interest. I am employed by the University of Miami. I have no financial interests to disclose.
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My name is Douglene Jackson. I will be speaking about managing challenging behaviors in children with neurodevelopmental disorders. I have no relevant financial interests or conflicts of interest. I am employed by the University of Miami. I have no financial interests to disclose. I am the Commission on Education Clinical Fieldwork Educator for the American Occupational Therapy Association and sit on both the Transition and Autism workgroups. I do not receive any compensation for my roles.
It’s ALL about U!
Your knowledge!Your skills!Your behavior!
Function of challenging behavior
Behavior predicts outcomes
Neurodevelopmental disorders do not walk alone (APA Spotlight on Disability, Sept 2016)Behavior problems 4x more common than in peers (Emerson, 2013)Impact access to care due to lack of trained professionals (Thompson, 2009)
Interventionists’ AimsYour GOAL is to:
Minimize the impact of challenging behavior onChild’s performance and participationYour ability to do your job
Understand the childModel skills for the parentUse evidence-based practice
Pyramid ModelThe pyramid model for supporting social emotional competence in infants and young children fact sheet
Public health model for promotion, prevention, and intervention Universal, secondary, tertiary approaches http://challengingbehavior.fmhi.usf.edu/do/py
ramid_model.htm
Reinforcement*Prompting*Time delay*ModelingTask analysis
Functional behavior assessment*Antecedent based intervention*Extinction*Response interruption/Redirection*Differential reinforcement of alternative, incompatible or other behavior (DRO)*Functional communication training*
Social skills training*Peer mediated instruction Social narratives*Structured play groupPECS
Visual supports*Discrete trial Naturalistic interventionParent implemented interventionPivotal response trainingScriptingExercise*
Computer assisted, SGDs, smartphones, tablets*Video modeling*
Overview
Goldilocks RuleChoices, choices, choicesSooner than laterCatch them being goodAnytime, AnyplaceLess is more
Not too big, not too small,not too loud, not too bright;not too fast, not too slow,not too hard, but just right!
Set the stageJust right fitPlan aheadMovement!
Visual SupportsVisual schedulesFirst/then boardsChoice boardsToken boardsTimers
ModelingPersonal Narratives
Choiceworks
iRewardFirst/Then
Visual supports: High Tech
Visual supports: Low Tech
Visual supports: Self-regulation
Visual supports: Self-regulation
A way to communicate without acting outAAC toolsAAC strategies
Positive reinforcementDifferential reinforcementRedirectionPromptingPlanned ignoringExtinction
Follow child’s leadEvery moment counts
From start to finishTeachable moments within visitsModel for families
Preparation and recoveryAnticipationCalm before the stormCalm after the storm
ABCs of behaviorAntecedents, Behavior, & Consequences
Your behavior matters!Time DelayChange your expectationsConsider the client
Self-regulation, Self-managementphysiological
Model for the parent
Take one minute to identify one strategy/intervention you would use with this child
Goldilocks RuleChoices, choices, choicesSooner than laterCatch them being goodAnytime, AnyplaceLess is moreIt’s ALL about U!
AFIRM Team. (2015/2016). FPG Child Development Center, University of North Carolina:
http://afirm.fpg.unc.edu/antecedent-based-interventionhttp://afirm.fpg.unc.edu/promptinghttp://afirm.fpg.unc.edu/reinforcementhttp://afirm.fpg.unc.edu/time-delayhttp://afirm.fpg.unc.edu/visual-supports
www.ccids.umaine.edu/resources/ec/visual-supports
http://zorten.com/token-board
http://learningworksforkids.com/apps/choiceworks/Stopbreathethink.orgBreatheThinkDo with Sesame Street KidConnect app (14+)Smiling Mind apphttp://learningworksforkids.com/apps/ireward-
chart/http://www.zonesofregulation.com/the-zones-of-
regulation-apps.html
E-book: A Beginning Step to Using Functional Behavior Assessment and Behavior Intervention Plans (2008) www.AutismClassroom.com
Calm Down [email protected] solutions for families: eight practical tipsfor parents of young children with challengingbehaviorwww.dds.ca.gov/HealthDevelopment/SARC/PositiveSolutionsforFamilies.pdfwww.tpt.comwww.gonoodle.comwww.do2learn.com
Bayat, Mojdeh. (2015). Addressing Challenging Behaviors and Mental Health Issues in Early Childhood. Council for Exceptional Children - RoutledgeBurge, P., Ouellette-Kuntz, H., Isaacs, B., & Lunsky, Y. (2008). Medical students views on training in intellectual disabilities. Canadian Family Physician, 54, 568-569)Dababnah S. & Parish S.L. (2016). Incredible Years program tailored to parents of preschoolers with autism: pilot results. Research in Social Work Practice, 26, 372-385Emerson, E. (2013) Prevalence of psychiatric disorders in children and adolescents with and without intellectual disability. Journal of Intellectual Disability Research, 47, 51-58)Masse, J., McNeil, C., Wagner, S., and Quetsch, L. (2016). Examining the efficacy of parent-child interaction therapy with children on the autism spectrum. Journal of Child and Family Studies, 25, 2508-2525Odom, S.L. & Wong, C.I. (2015). Connecting the dots: supporting students with ASD. American Educator
Thompson, J.R., Bradley, V., Buntinx, W.H.E., Schalock, R.L., Shogran, K.A., Snell, M.E., Wehmeyer, M.L. et al. (2009). Conceptualizing supports and the support needs of people with intellectual disability. Intellectual and Developmental Disabilities, 47, 135-146Totsika, V.I., Hastings, R.P., Emerson, E., Lancaster, G.A., and Berridge, D.M. (2011). A population-based investigation of behavioural and emotional problems and maternal mental health: associations with autism spectrum disorder and intellectual disability. Journal of Child Psychology and Psychiatry, 52, 91-9. doi: 10.1111/j.1469-7610.2010.02295.x. Weiss, J.A., Baker, J.K., & Butter, E.M. (2016). Mental health treatment for people with autism spectrum disorder (ASD): Fostering the mental health needs of people with ASD. Spotlight on Disability Newsletter, 8. Retrieved from http://www.apa.org/pi/disability/resources/publications/newsletter/. Wong, C.I., Odom, S.L., Hume, K.A., Cox, A.W., Fettig, A., Kucharczyk, S., Brock, M.E., Plavnick, J.B., Fleury, V.P., and Schultz, T.R. (2015). Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review. Journal of Autism and Developmental Disorders, 45, 1951-1966. doi:10.1007/s10803-014-2351-z
