Friday, March 12, 2010 Carol Ann Davis, EdD University of Washington cadavis1@uw

1. Addressing the Social and Behavioral Needs of Students with Autism and Other Developmental Disabilities Friday, March 12, 2010 Carol Ann Davis, EdD University of Washington cadavis1@uw.edu

2. Characteristics of Positive Behavior Support • Assessment-based: Interventions directly linked to environmental influences and a hypothesis concerning the function of the problem behavior. • Comprehensive plans, usually involving multiple interventions • Proactive, involving teaching alternative skills and adapting the environment. • Emphasizes lifestyle enhancement and inclusive settings as both the context for and long-range goals of intervention.

3. Characteristics of Positive Behavior Support (cont.) • Reflects person-centered values that honor the dignity and preferences of the individual. • Designed for use in everyday settings using typically available resources. • Broad view of intervention success that includes (a) increases in the use of alternative skills, (b) decreases in the incidence of challenging behavior, and (c) improvements in quality of life.

4. Conduct Assessments Assessment of the Environment Explicit Implicit Assessment of Instruction and Adult - Child Interactions Increase in Teacher Time and Level of Intrusiveness Assessment of Antecedents and Consequences

5. Evaluate the Environment (Environmental Checklist)

6. Changes in the Environment (Interventions) • Visual supports • Arranging the room (defining specific areas in the room) • Limiting the number of children in an area • Zone staffing • Post and teach rules and procedures • Use novel materials or rotate materials

7. Instructional Checklist

8. Strategies to Influence Behavior by Changing the Instruction Content • Include individual child preferences • Break the tasks into simple steps • Make the task meaningful and functional Presentation • Shorten the length of the task • Provide choices • Insure child success (errorless learning) • Vary the difficulty of the tasks (intersperse mastered with new) • Provide unsolicited attention

9. Obtain Desirable Events Avoid/Escape Undesirable Events Internal External Internal External Attention Objects/ Activities Objects/ Activities Attention • Difficult • tasks • Change in • routine • Interruption • of desired • activity • Rhythmic • rocking • Endorphin • release • Visual • stimulation • Smiles, • hugs • Frown, • scolding • Surprise • Smiles, • hugs • Frown, • scolding • Surprise • Sinus • pain • Skin • irritation • Hunger • Food • Preferrred • activity • Money

10. What is a FBA? • A process that: • Defines the target behaviors • Determines the environmental events and factors that contribute to challenging behaviors • Identifies the antecedents and consequences that occur before and after the challenging behaviors • Hypothesizes the function or purpose of the challenging behaviors • Provides direction for developing appropriate and effective positive interventions

11. FBA is a process in which many instruments may be used to gather information • Reviewing existing documents • Interview • Scale or Screening Instruments • Scatterplot • Direct Observation Tools • Environmental Manipulation

12. Introduction of Case Study Nick is a 8 year old boy who attends a local school. He is in a self-contained classroom with students with a variety of severe disabilities. Nick was diagnosed with autism at 2.5 years old. He has limited verbal skills but will use “I want …” frequently to request items or people. Nick loves to fidget with action figures and likes to listen to music. Nick likes to verbally label pictures and look at books during academic times. Nick has demonstrated significant challenging behaviors including head-banging (fist to temple, fingers to bridge of nose), other bodily injury (knocking knees together, banging wrists together, banging wrists on table, biting wrists), object banging (using multiple objects to bang against head), and aggression towards others (biting, kicking). Nick lives at home with three sisters, mother, and father. His mother drives him to and from school as Nick has been demonstrating self-injurious behaviors while on the bus. His mother reports that she is seeing similar behaviors at home but not with the same intensity.

13. Existing Written Documents • Medical records • Previous IEP/IFSP • Social Work/Counseling Reports • Reports from previous service providers

14. What events do I need to consider when I begin an intensive FBA? Setting Events • Conditions that increase the likelihood that problem behavior will occur. They can be: • Removed in time from the behavior (e.g., the child wakes up late, is rushed through breakfast, and hurried out the door to daycare two hours before she refuses to clean up her toys) • In close proximity to the behavior (e.g., the child has a block taken from him immediately prior to hitting another child in that center; student has a bad interaction in the hallway prior to screaming at the teacher) Example • An ongoing situation or state (e.g., the student is extremely fatigued due to a cold and not sleeping well the night before).

15. Setting Event Checklist Case Study

17. Another Example

18. Setting Events • Bad interaction with family previous to school • Sick, Hungry, Tired • Was reprimanded in class and privilege taken away

19. Motivation Assessment Scale • A 16-item survey that assists in developing a hypothesis about the function of the problem behavior http://www.monacoassociates.com/mas/index.html

20. Motivation Assessment Scale

21. Interviews An interview that describes the problem behavior and identifies physical and environmental factors that reliably result in the problem behavior.

22. Interview Information • What exactly does the behavior look like? • What do you think is the function of the behavior? • What events/situations predict the behavior? • What are the learning characteristics? • What does the child like or not like? • How does the child communicate needs, wants, etc.? • What are some of the other factors (e.g., medical, schedule) that may influence behavior?

23. Scatterplot • An interval recording system that assists in determining if patterns of problem behavior exist during specific time periods

24. Scatterplot Form 0 1 2 - 3 > 3 Time/Activity 9/12 9/13 9/14 8:00 - 8:20 8:20 - 8:35 8:35 - 9:15 9:20 - 9:35 9:35 - 9:55 9:55 - 10:30

25. Scatterplot Form Case Study <5 6-10 11-15 > 15 Time/Activity 9/12 9/13 9/14 8:00 - 8:15 8:15 - 8:30 8:30 – 8:45 8:45-9:00 9:00 - 9:15 9:15 - 9:30

26. Scatterplot Form Activity Time/Activity

27. Scatterplot Form 0 1 2 - 3 > 3 Time/Activity 7/28 7/29 8:00 – 8:30 8:30 – 9:00 9:00 - 9:30 9:30 – 10:00 10:00-10:30 10:30 - 11:00

28. ABC Analysis • Event recording system that determines patterns of antecedents and consequences associated with a particular behavior.

29. Antecedent-Behavior-Consequence Analysis Date Antecedent Behavior Consequence

30. What do I do with all of this? (i.e., How do I summarize the data?) Evaluate the antecedent that are predicting the behavior

31. What do I do with all of this? (i.e., How do I summarize the data?) Evaluate the consequences that are maintaining the behavior

32. What do I do with all of this? (i.e., How do I summarize the data?) Evaluate the whole sequence

33. 2 What do I do with all of this? (i.e., How do I summarize the data?) Evaluate the antecedent that are predicting the behavior

34. 2 What do I do with all of this? (i.e., How do I summarize the data?) Evaluate the consequences that are maintaining the behavior

35. 2 What do I do with all of this? (i.e., How do I summarize the data?) Evaluate the whole sequence

36. ABC Analysis Case Study

37. Summarize Eric’s Data Evaluate the whole sequence No attention: Teacher with another student Teacher tells him to work quietly Disruptive (humming) X No attention: Teaching walking around classroom Disruptive (sighing, tapping pencil) Teacher walks to Eric & helps him X No attention: Teacher at the board Disruptive (tapping table) Teacher talks to Eric & Eric goes to the bathroom X X

38. Environmental Manipulation • Systematic manipulation of environmental variables that you believe will and will not result in the demonstration of the problem behavior. • Can only be used when it is possible for the interventions to manipulate the relevant factors (hot vs. cold, tired vs. awake) • Potential benefits of the procedures should be weighed against the potential risks to the student • Required consent • Strategies should be developed to ensure safety of the student, the interventionist, and others in the environment • This is just an overview.

39. Environmental Manipulations

40. Environmental Manipulations Antecedent – variables are set up in advance and are not contingent on problem behavior (e.g., student is given hard task versus an easy task; low attention versus high attention) • Based on the ABC, identify the variables that are likely to influence problem behavior. • Identify a time period and situation that can be set up to test your hypothesis (e.g., high rates of attention and low rates of attention). • Collect data on the problem behavior that occurs in each condition • Conduct the conditions across several days, testing each condition at least two times.

41. Antecedent Manipulation Case Study Hypothesis: Given an academic demand, Nick will bang his head to avoid doing the work. FA could help determine if the subject of the task influenced the rate of head banging.

42. Case Study • Develop a hypothesis about two variables that you believe to influence challenging behavior • In the same setting, test out those two variables related to their effects on the student’s behavior

43. Environmental Manipulations Consequence – variables to be tested are presented contingent on problem behavior exhibited by the student. • Based on the ABC, identify the variables likely to influence problem behavior. • Identify a time period and conditions that can be set up to test your hypothesis. • Based on problem behavior, variables are implemented. For example: • During an escape condition, when the problem behavior occurs, the task is removed • During an attention condition, when the problem behavior occurs, attention is provided • During a tangible condition, when the problem behavior occurs, a tangible item is provided

44. Developing a Hypothesis Statement • Hypothesis statements are developed for each behavior. • Review the data to identify patterns: • Under what condition does the behavior occur? • What happens when the behavior occurs? • Summarize when X happens, S engages in problem behavior to get Y

45. Hypothesis Development

46. Case Study Given a math assignment, Nick will bang his head to escape his math work.

47. Developing a hypothesis statement • Using your example student, develop a hypothesis statement for each behavior.

49. Questions?