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Positive Behavior Support:Changes That Last
Jane I. Carlson, PhD, BCBA
Autism Center of Virginia
Virginia Commonwealth University
Historical Perspective
Internal Validity Experimental Control Statements of
Causation
New Perspective
External Validity Lifestyle Change Practical and Relevant Long-term Change
6-year Longitudinal Study
Goals: Demonstrate Effectiveness of PBS
Implementation by Key Stakeholders
Long-term Maintenance of Effects
Criteria for Inclusion
Severe Problem Behavior Excluded from Community Activities Required Physical Restraint or Medical
Attention Some Communicative Ability
Participants
Name Age
(at start)
Diagnosis IQ Communic-ation
Val 14 CP with ataxia
30 Short Phrases
Poor Articulation
Gary 17 MR
Autism
28 Short phrases
Juan 38 MR
Autism
12 10 words
Picture Symbols
Three-part Approach
AssessmentInterventionMaintenance
Assessment Phase
DescribeCategorizeVerify
Describe: InterviewDirect
Observation
A – B – C
Antecedent-Behavior-Consequence
Categorize: Identify Function
Identify Context
Functional Categories
AttentionEscapeTangiblesOther
Verify:Manipulate
Context (A)Manipulate social
reaction (C)
Intervention Components
Building Rapport Functional Communication Training (FCT) Building Tolerance for Delay of
Reinforcement Providing Choices Embedding
Build Rapport Increase positive social interactions.
Provide reinforcers.
FCT: Teach functionally
equivalent communication.
Address all functions. Teach in all contexts
Crisis Management
Ignore Momentary restraint Protect Remove Introduce cues
Building tolerance for delay of reinforcement:
Acknowledge request. Specify contingency. Prompt performance. Prompt communication. Reinforce.
Providing Choices:
When request can’t be honored.
Activity Choices. Reinforcer choices.
Embedding: Intersperse SD for problem behavior with SD’s for socially appropriate behavior.
Generalization: PeopleSettingsTasks
Mean Frequencies of Spontaneous Communication
Participant Baseline Intervention Maintenance
Val 23 61.8 45.4
Gary 9.3 54.1 25.1
Juan 7.6 52.5 59.2
Mean Frequencies of Problem Behavior
Participant Baseline Intervention Maintenance
Val 243 3.4 1.0
Gary 77.4 5.5 6.4
Juan 110 9.5 1.7
Mean Percentage of Task Engagement
Participant Baseline Intervention Maintenance
Val 6% 41% 69%
Gary 36% 54% 70%
Juan 25% 35% 39%
Social Validity
Future Directions
Assessment PracticesIntervention PracticesOutcomes