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Behavior Management of Children with Severe Disabilities. Martin E. Block, Ph.D. Curry School of Education University of Virginia. Outline. Review Types of Behavior Problems Review Two Major Approaches to Treatment Review Terminology Outline Format to Develop Behavior Plan.

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Behavior Management of Children with Severe Disabilities

Martin E. Block, Ph.D.

Curry School of Education

University of Virginia


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Outline

  • Review Types of Behavior Problems

  • Review Two Major Approaches to Treatment

  • Review Terminology

  • Outline Format to Develop Behavior Plan


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Types of Behavior Problems

  • Stereotypic Behavior

  • Self-Injurious Behavior

  • Aggression

  • Non-compliant/Disruptive Behavior

  • Inappropriate Social Behavior

  • Disorders of Physical Regulation


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Stereotypic/Self-Stimulatory Behaviors

  • Repetitive cycles of behavior that persist for long periods of time.

    • Body rocking

    • finger flicking

    • hand flapping

    • tapping objects

  • Cause - may stimulate/entertain child

  • Problem - interferes with learning; prevents community placement


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Self-Injurious Behavior

  • Response that inflicts direct harm on the individual.

  • Cause - unknown. May have higher levels of pain tolerance, gets attention, organic (e.g., Lesch-Nyhan), may somehow act as a natural opiate through production of endorphins in the CNS.

  • Problem - physical harm, inappropriate behaviors prevent community living.


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Aggression

  • A behavior that represents a danger to the client or others. Generally means act of physical violence against others.

  • Cause - fear (escape fearful situation), anger (frustration or anger), manipulation of others (get them to do what you want or escape demands of situation)

  • Angry aggression often occurs as part of tantrum - crying screaming, thrashing out, attacking others, damaging property


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Non-compliant/Disruptive Behavior

  • Refusing reasonable requests, running off instead of coming when called, becoming limp and dropping to the floor, resisting transitions, not performing chores or duties.

  • Cause - attempt to control others/situation, attempt to exert independence and some control over one’s activities


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Inappropriate Social Behavior

  • Failure to have learned more appropriate social skills and rules - stripping, showing affection to strangers, stealing or hoarding, lying, masturbating in public, swearing/shouting.

  • Cause - no inhibition, not aware of how others view them, not knowing social rules


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Disorders of Physical Regulation

  • Limited physical control due to failure to acquire (or loss of) self-regulation over bodily functions - copresis, enuresis, drooling, and tongue thrust

  • cause - physical problems coupled with failure to try and teach self-regulation

  • treatment might include adaptations (e.g., diaper, bib) and teaching tolerance



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Elimination Approach

  • Views behavior problems as maladaptive or interfering actions that make it impossible or difficult for children to learn

  • Goal is to eliminate these behaviors - undesirable behaviors must be eliminated before new, adaptive behaviors can be taught


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Elimination Approach (Cont.)

  • Negative behaviors are regarded as high priority intervention goals because they are viewed as interfering with learning.

  • Entire IEP’s are often devoted to decelerating or stopping behaviors rather than teaching new skills


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Elimination Approach (Cont.)

  • Some behaviors are perceived as being so disruptive that special staff is called into to deal with the child.

  • Some children are viewed as needing to be put into a special class or school for children with similar behaviors in order to carry out an elimination program.


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Problems with Elimination Model

  • Does it really work?

  • Might something else have worked better?

  • Is it wise to postpone teaching other skills?

  • These programs often involve aversives

  • Programs often involve homogeneous groupings


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Educative Approach

  • Major purpose is to encourage adaptive behavior and promote maximum participation of individual in meaningful, daily activities.

  • Instruction is not delayed until behaviors are under control. At best deceleration programs are supplemental to active treatement


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Educative Approach (cont.)

  • Not all behavior problems are equal priority targets for behavior change.

  • Most effective strategy to reduce behaviors might be to replace it with a skill that accomplishes the same function.

  • Deceleration programs do not use aversives



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Compare Our Lifestyle with a Person with a Disability

  • Choices/Control

  • People

  • Things

  • Activities

  • Community Experiences



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Prioritizing Behaviors

  • Level I: Urgent behaviors requiring immediate attention

  • Level II: Serious behaviors requiring formal consideration

  • Level III: Excess behaviors reflecting normal deviance



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A - B - C Analysis

  • Antecedent (stimulus) - an event occurring prior to a behavior which in some way influences that behavior

  • Behavior (response)- any observable or measurable act by an individual

  • Consequence - an event that occurs after a behavior has been exhibited and in some ways is influenced by or related to the behavior.


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Reinforcement

  • Applying a technique that results in an increase in a targeted behavior.

    • Positive reinforcement - present something positive that increases targeted behavior.

    • Negative reinforcement - take away something aversive that increases targeted behavior


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Types of Reinforcers

  • Primary - unconditioned reinforcer, one that does not have to be learned to be effective (food, water, and other necessities of life)

  • Secondary - a conditioned reinforcer, one that is learned

    • activity/sensory - a reinforcer that involves participation in an event or sensation

    • Token - receiving an item that can be exchanged

    • Social - a reinforcer that involves interaction between two or more persons.


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Other Types of Reinforcers

  • ALT-R (strengthen incompatible behaviors)

  • DRL (reinforce lower amounts of behaviors)

  • DRO (reinforce other behaviors)

  • DRT-O (reinforce others in general area)


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Reinforcement Schedules

  • Continuous - everytime child exhibits targeted behavior (best initially for establishing a behavior)

  • Intermittent - reinforce sometimes

    • fixed - same number every time (every 3rd try)

    • variable - average number (between 3rd and 5th try)


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Punishment

  • Presentation of an aversive event or consequence that leads to a decrease in targeted behavior.


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Other Key terms

  • Cue - a signal, sign, request, or information that calls for the occurence of a behavior.

  • Response cost - removal of a specific quantity of reinforcement.

  • Time-out - removal from a reinforcing situation

  • Extinction - a reinforcer that previously sustained a behavior is withheld for the purpose of eliminating that behavior


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Other key terms (continued)

  • Over-correction - making individual do restitution for what he/she has done plus extra work

  • Desists - verbal reprimands

  • Satiation - providing a reinforcer for so long or so often thatit has lost its effectiveness



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Creating the Behavior Plan

  • Define Behavior in Observable, measurable terms.

  • Observe the Behavior

    • when does it occur

    • where does it occur

    • why do you think it occured


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Creating the Plan (Continued)

  • Explore the Consequences

    • what happened when the behavior occurred

    • when did these consequences take place

    • how did the student respond to these consequences


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Creating the Plan (Continued)

  • Consider Alternatives

    • moving student

    • regrouping class

    • rearranging environment

    • changing time of activity

    • changing class format

    • other possible ideas


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Creating the Plan (Continued)

  • Clearly State the Desired Goal

  • Outline Procedure for Preventing/Reducing Behavior

    • Describes cues you will use

    • describe reinforcers you will use

    • describe how you will present reinforcers

    • describe what you will do if behavior occurs


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