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POSITIVE MANAGEMENT FOR CHALLENGING BEHAVIORS

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  1. 1. POSITIVE MANAGEMENT FOR CHALLENGING BEHAVIORS IN CHILDREN WITH SPECIAL NEEDS Stacy Carmichael, PhD ABPP Licensed Psychologist Board Certified, Clinical Child & Adolescent Psychology
  2. 2. -Walter Barbee If youve told a child a thousand times, and he still does not understand, then it is not that child who is the slow learner.
  3. 3. What is behavior management? Behavior management is not an attitude adjustment Systematic method of increasing or decreasing behaviors Teaching appropriate behaviors and coping skills (discipline means to teach) What are behaviors? You can see them, hear them and measure them if needed
  4. 4. Children with special needs at increased risk of inappropriate behaviors because: They are not at the developmental level of same age peers or siblings Adults or children may not know what to expect Motor planning difficulties, sensory concerns Cognitive delay, processing delay Difficult understanding abstract concepts such as time, waiting Difficulty expressing wants, needs, feelings Anxiety Not understanding the perspectives and motives of others As parents we may feel guilty and over-protect
  5. 5. Prioritizing behaviors to address How harmful is this behavior to your child or other children/adults? How does this behavior interfere with your childs development and learning? How does this behavior interfere with your childs participation in family or peer activities? How does this behavior interfere with positive social relationships/acceptance?
  6. 6. Common challenging behaviors Wandering Biting/hiting/kicking/throwing (aggression) Yelling/screaming/tantrums Non-compliance with requests Attentional concerns Lack of initiative/difficulty organizing behavior Toileting Sleeping Eating Playing/social skills
  7. 7. We teach. If a child does not know how to read, we teach. If a child does not know how to swim, we teach. If a child does not know how to multiply, we teach. If a child does not know how to drive, we teach. If a child does not know how to behavior.we..teach? ..punish?
  8. 8. Punishment vs reinforcementwhat is going on? Operant conditioning (BF Skinner) Reinforce- to strengthen the probability of the behavior Punish- to decrease the probability of behavior POSITIVE STIMULUS NEGATIVE STIMULUS PRESENTED Positive Reinforcement (winning lottery) Positive Punishment (speeding ticket, yelling, spanking) TAKEN AWAY Negative Punishment (Taking away cell phone when teen breaks curfew) Negative Reinforcement (putting anti-itch ointment on bug bite)
  9. 9. Universal Preventative Practices Review routines IF-THEN/earning Routines are clear, consistent (calendars, visual schedules, visual timers for transitions) Review Physical Arrangements (tv, computer, homework area, calm-down area, etc) Define and teach expectations and skills Positive house rules (use respectful language, pick up after yourself, put toys away before you get new toys..respect others, yourself and property) Plan systematic responses To appropriate behaviors To inappropriate/challenging behaviors
  10. 10. What kind of boss are you? Worst Supervisor Best Supervisor
  11. 11. What kind of boss are you? Makes unreasonable demands for my level Keeps changing his mind Has unclear expectations Never says Thanks or Good job Keeps things fair Sticks to the plan and keeps me informed Rewards all successes, big and small Shows respect and compassion Takes responsibility as the boss Worst Supervisor Best Supervisor
  12. 12. Special time Improves the positivity of the parent-child relationship 15 minutes daily, child directed interaction with a specific skill-building activity No questions, no criticisms, no commands P praise, labeled R reflect important comments from your child I -imitate what you child is doing that you like D describe what your child is doing (sports announcer) E be enthusiastic!
  13. 13. Increasing appropriate behavior: Attention, Praise and Rewards CATCH KIDS BEING GOOD! ROUTINES VISUAL CUES/SUPPORTS TO KNOW WHAT TO EXPECT AND DO Positive attention Make positive attention specific Give positive attention right away Use powerful rewards that are not usually accessed Avoid criticism Tell your child WHAT TO DO, not what NOT to do (Bottom on the seat please. Hands to your sides.) May use visual aides, photos or video models. TELL-SHOW-DO Carry out promises, so make a request only if you have time to wait and follow through Praise frequently Set them up for success with tasks you know they can do. Plan ahead to eliminate or decrease triggers (hunger, fatigue, crowds)
  14. 14. Ex: behaviors to praise Sharing toys Talking quietly Asking for help Nice manners Being flexible Being patient Expressing feelings Not interrupting Waking up on time Getting dressed on time Being creative Calming down when upset Walking softly Starting homework Making bed Putting away clothes Encouraging others Using humor Apologizing Being friendly Brushing teeth or hair Starting a new hobby Helping parent Picking up after self Telling the trying Complying with a time limit
  15. 15. Can you praise too much? Great expectations trap? Possible Dont praise indiscriminately, talk about specific facts Focus on the EFFORT not the results, again encourage Teach your child that its okay to make mistakes, not be perfect, that is part of learning
  16. 16. Rewards Types of rewards Verbal or social rewards (praise, hugs, high fives, games) Physical/non-social rewards (snacks, staying up or preferred food, tokens or points to redeem for desired object) Activity/sensory rewards (access to games, tv time, ipad time, music, blowing bubbles) For Effective rewards: Use rewards immediately Initially reward the behavior every time it occurs Reward only the behaviors you want to increase Billy, I liked the way you picked up your toys the first time I asked! That makes mommy really happy.
  17. 17. Time-In Positive interactions and feedback children receive when engaging in appropriate behavior Critical to quality of parent-child relationship CATCH THEM BEING GOOD! Doesnt have to be a special occasion. Be specific, label your praise. Provide physical attention. Give immediate feedback. Avoid back-handed compliments. Use third-handed compliments. Plan parent-child activities that set them up for time-in.
  18. 18. Uh-oh, now what? Ignore the behavior (extinction) if it is mild and only used to gain attention (planned ignoring) Redirection to another activity or appropriate behavior is often helpful, provide choices Removal from a situation or reinforcement (time-out) Try not to feed into the behavior to give him/her what she wants, lecture/threaten, show anger or disappointment, be physical
  19. 19. Time out Only helpful if time-in encourages appropriate behaviors and allows access to desired reinforcers (attention, toys.) Thus, it is actually time-out from positive reinforcement (no talking to, warnings, looking at, or access to reinforcers or escape from tasks.) Lead child away to time-out area, tell them why and how long they will be in time-out. Use visual timer, no more than 5 minutes, about one minute for every year of cognitive age. Immediately after, remind them why they went to time- out, review how to handle the situation in the future, and immediately begin time-in and provide positive reinforcement for appropriate behaviors. More at the Center for Effective Parenting, Parenting-ed.org
  20. 20. Ideas for decreasing challenging behavior First try to increase appropriate behaviors so that it provides the functional equivalent for the child. Avoid giving attention to child during problem behavior. During problem behavior, dont escalate, simply remind child about what they can DO rather than NOT DO (You could use your words to ask your sister to share.) After the problem behavior, provide immediate praise for appropriate behaviors.
  21. 21. Research on PBS Effective for all ages of individuals with disabities ages 2-50 years Effective for diverse groups of individuals with challenges: intellectual disability, oppositional behaviors, autism, emotional concerns etc PBS so far is the only comprehensive and evidence based approach to address problem behaviors within a variety of natural settings.
  22. 22. Positive Behavior Support General intervention for all behavior problems Intervention is reactive (decreased outside activity, restraint, spanking) Focus on behavior reduction Quick fix Only the family involved Intervention matched to purpose of behavior Intervention is proactive Focus on teaching new skills Long term interventions Involves family, teachers, therapists, admins, etc. Old Way New Way
  23. 23. Positive Behavior Support Plans Simply TOOLS to help children be more successful in participating and succeeding in everyday life. -A Parent Remove the triggers to prevent problems Be proactive-set them up for success Eliminate the reinforcement of inappropriate behavior Provide skill instruction to build appropriate behaviors or communication and decrease need for child to engage in challenging behavior Increase reinforcement of appropriate behaviors decrease reinforcement of challenging behaviors
  24. 24. ABCs of Behavior Antecedent (what happened BEFORE) Behavior (what do you need to change) Consequence (what happens after the behavior)
  25. 25. Common triggers of misbehavior Pain, illness GERD/Reflux GI concerns/constipation Thyroid concerns Vision/hearing concerns Sleeping difficulties (apnea) Emotional distress-anxiety, depression Hungry, tired
  26. 26. Example of a rapid Functional Behavior Analysis Find at: http://csefel.uiuc.edu (Center on the Social and Emotional Foundations for Early Learning)

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