presentation handout [read-only] - tasp.memberclicks.net · pica (eating inedible objects) common...

10/7/2013

1

Understanding and Managing Challenging

Behavior in the Classroom

Dorothea C. Lerman, Ph.D., BCBA-D

Professor of Psychology, UHCL

Director, UHCL Center for Autism and Developmental Disabilities

Understanding and Managing Challenging

Behavior in the Classroom

Dorothea C. Lerman, Ph.D., BCBA-D

Professor of Psychology, UHCL

Director, UHCL Center for Autism and Developmental Disabilities

What is a problem behavior?

� Harmful to a person

The individual or other people

� Interferes with normal interactions

Prevents inclusion in programs

Hinders social relationships

� Interferes with appropriate behavior

Prevents skill development

Poses a barrier to achievement

� Aggression (hitting, kicking, biting others, etc.)

� Tantrums (crying, yelling, spitting)

� Property Destruction (throwing materials, breaking things)

� Noncompliance (refusal to following instructions, flopping)

� Elopement (running away)

� Self-Injurious Behavior (head hitting, biting self, hand mouthing)

� Stereotypy (hand flapping, body rocking, spinning objects)

� Pica (eating inedible objects)

Common Forms of Problem Behavior

10/7/2013

2

Why Does it Happen?

�Most problem behaviors are learned

• Appropriate & problem behavior can occur for similar

reasons

� It’s a way to communicate

• It gets the individual something that is desired

� Influenced by things happening in the immediate

environment

• Antecedents: before behavior (“triggers”)

• Consequences: after behavior (“pay off”)

� Understanding problem behavior

• Know the “triggers” and “pay offs”

• Or, in other words, determine the “function” of the

behavior

The Role of Other People

� These “triggers” and “pay offs” often involve the behavior

of other people

� Things we do can change the likelihood of problem

behavior occurring

Example: Saying “no” following a request

� Things we do can keep problem behavior going in the

future

Example: Giving things to the person to calm him/her

down

This means that we need to change our

own behavior too!!!!

Understanding Behavior

Antecedent � Behavior � Consequence

Antecedents (“Triggers”):

� Occur immediately before a behavior

� Impact the frequency and intensity of behavior

Examples:

Little or no attention from others

Something taken away or not available

Asked to do something

10/7/2013

3

Understanding Behavior

Antecedent � Behavior � Consequence

Consequences (“Pay off”):

� Occur immediately after a behavior

�What the behavior “gets them”- reaction, items, etc.

�Makes behavior more likely to occur again in the future

Examples:

Attention

Access to desired objects

Escape or avoid tasks

Main Functions of Problem Behavior

Attention

People are quick to learn that engaging in problem behavior can get them lots of attention.

Any form of attention can be desirable - even stern looks, reprimands, and restraint.

“There’s no such thing as bad press.”


Tangibles

Problem behavior can get them access to things they want (e.g., leisure materials, food), particularly things that have been restricted or denied (“5 more minutes!”)

10/7/2013

4

Case Illustrations

John is an 11-year-old boy with a language disability. He has few friends

and is heavily dependent on attention from his teacher. John has

learned that one means of getting attention from this teacher is to

disrupt the class by running around and screaming.

Sue is a 15-year-old teen with mild mental retardation. Her favorite

activity is watching television but her mother only permits her to

watch television for 30-minutes each day. Sue has learned that her

mother often will "give in" and allow her to watch additional

television if she screams and drops the floor.


Escape or avoid things they don’t like

People are quick to realize that misbehavior will result in getting them out of things they don’t like

This may happen when a person is placed at a desk with work, asked to help with chores, is told it’s time for a bath or bed, or is in the presence of aversive events (loud environments, close proximity to others, etc.)

10/7/2013

5

Case Illustrations

Earl is a 10-year-old student with a learning disability. He has a great deal

of difficulty with individual seat work. Earl has learned that his teacher

will remove his work if he yells and bangs his hand on the desk.

Valerie, a 6-year-old, prefers to play alone and does not like other students

to approach her on the playground. She has learned that other students will

stay away from her if she bites the students whenever they approach her.

The teacher also quickly moves other students away from her when she

threatens to bite.


Sensory Stimulation

The consequences are not provided by anyone else (person engages in the behavior when alone)

• Access to pleasurable stimulation (e.g. rocking)

• Escape from aversive stimulation

Case Illustrations

Bob is a 4-year-old student with severe Autism. He rarely plays with toys and does not enjoy interacting with others. He has learned that flapping his hands in front of his eyes and body rocking produce pleasurable stimulation.

Charles is a 5-year-old student with a profound language disability. He has suffered from chronic ear infections for several years. He has learned that hitting his ear with his fist will sometimes lessen the pain in his ear.

10/7/2013

6

How Do We Identify Function?

“Functional Behavioral Assessment” (FBA)

Any formal method used to identify antecedents and

consequences that are related to a particular behavior

In other words, when and why does it occur?

How to Identify Function

� Indirect assessment

• Interviews, checklists, questionnaires, etc.

• Often inaccurate or incomplete information

� Descriptive assessment

• Watch and record what happens normally

• Identifies important events around behavior

� Functional analysis

• Arrange “situations” to see when most problem behavior

occurs

• “Gold standard” in behavioral assessment

• Requires training to do this safely & correctly

A Brief Overview of The Assessment Process

Step 1: Problem Definition

1. Begin with general description of problem (e.g., does not

follow directions, is hyperactive, is aggressive towards

others)

Example :Bob is aggressive towards peers and teachers.

2. Develop "operational definitions" so that everyone

understands what is an instance of the behavior

Example: Bob strikes, kicks, scratches, and grabs clothing of

peers and teachers. He also makes verbal threats of

violence (e.g., "I'm going to break your arm")

10/7/2013

7

Step 2: Indirect Assessment: Verbal report from teachers/caregivers about the behavior and the conditions under which it occurs.

� To clarify the nature of the problem

� To obtain information that will guide additional assessments

Use a structured format: improves consistency

Examples: Questionnaires, Checklists, Rating Scales

Obtain information from several people who are knowledgeable about the person (teachers, parents,

etc.)

What Does the Research Say About Indirect Assessment?

�Moderate to low reliability and validity

� Not adequate to identify behavioral function

Generates useful information to guide additional

assessment:

When, Where, and What to observe

Step 3: Descriptive Assessment: Direct observation of the

behavior and events that immediately precede and follow

it

Helps us..

� Gather information/data through direct observation

� See patterns/commonalities

� Develop hypotheses about the function of the behavior

10/7/2013

8

NarrativeA-B-C Recording

You simply writes down events as they occur

• What happened right BEFORE the behavior?

Was the individual being ignored?

Was something denied?

Was the individual told to do something?

• What happened right AFTER the behavior?

Was the individual given attention?

Did the individual receive something such as food or a toy?

Was a request or demand removed?

• Focus on immediate antecedents and consequences (occur within

10 seconds of the behavior)

Narrative A-B-C (Antecedent – Behavior – Consequence) Assessment

Hand-biting – placing any part of the

hand past the plane of the lips

Elopement – attempting to leave

designated area without permission or

supervision





supervision





supervision



Told him to stop running out of the room and showed him the rules of the class. Made him sit by me.

The class was watching a movie. I was doing paperwork at my desk.

XElopement – attempting to leave


supervision

XHand-biting – placing any part of the


Told him to keep his hands quiet and helped him sit on them so he couldn’t bite anymore.

Working with Bobby one-on-one. Another teacher came in to the class and asked me to get something for her.



supervision



Ms. Johnson ran and got him. She told him he can’t run off like that because he could get hurt, and showed him the rules of the classroom.

Bobby was sitting at circle time with the other students. We were going around the circle, talking about the weather, and I was working with another student who was being difficult.

xElopement – attempting to leave


supervision

Immediate consequence:Immediate antecedentBehaviors (List specific problem ):





supervision





supervision





supervision



Told him to stop running out of the room and showed him the rules of the class. Made him sit by me.

The class was watching a movie. I was doing paperwork at my desk.



supervision



Told him to keep his hands quiet and helped him sit on them so he couldn’t bite anymore.

Working with Bobby one-on-one. Another teacher came in to the class and asked me to get something for her.



supervision



Ms. Johnson ran and got him. She told him he can’t run off like that because he could get hurt, and showed him the rules of the classroom.

Bobby was sitting at circle time with the other students. We were going around the circle, talking about the weather, and I was working with another student who was being difficult.

xElopement – attempting to leave


supervision


Narrative A-B-C (Antecedent – Behavior – Consequence) Assessment





supervision





supervision





supervision



She got up and got him and he flopped on the ground. She brought him back to the classroom to eat.

The class was all eating lunch in the lunchroom. Ms. Smith was sitting next to him, telling him he needed to eat the fruit he had before he ate his candy.



supervision



Ms. Jones told him to stop running. She brought him back to class and said she couldn’t work with him today because he was being too difficult.

Eddie was at speech therapy with Ms. Jones, working on prepositions.



supervision



He was kept in classroom instead of going to gym.

Eddie was told to go to gym class. Elopement – attempting to leave


supervision






supervision





supervision





supervision



She got up and got him and he flopped on the ground. She brought him back to the classroom to eat.

The class was all eating lunch in the lunchroom. Ms. Smith was sitting next to him, telling him he needed to eat the fruit he had before he ate his candy.



supervision



Ms. Jones told him to stop running. She brought him back to class and said she couldn’t work with him today because he was being too difficult.

Eddie was at speech therapy with Ms. Jones, working on prepositions.



supervision



He was kept in classroom instead of going to gym.

Eddie was told to go to gym class. Elopement – attempting to leave


supervision


10/7/2013

9

Interpreting the Results

� Look for a pattern

Common antecedents?

Common consequences?

� Determine the possible function

• May not always be the same across behaviors and

situations

� Narrative recording is “free form” and can be difficult to use

and interpret

Structured A-B-C Recording

� Potential antecedents/consequences are listed on data

sheet

� When the behavior occurs, mark the antecedent,

behavior, and consequence from listed options

� Collect data repeatedly over time in all relevant settings

and at times the behavior is likely to occur

� Summarize data to develop hypotheses about function

Structured ABC Recording

√√√√

√√√√

√√√√ √√√√

√√√√

√√√√

√√√√

√√√√

√√√√ √√√√

√√√√

√√√√√√√√ √√√√

√√√√

√√√√ √√√√

√√√√

√√√√

√√√√

√√√√

√√√√√√√√

√√√√

√√√√√√√√

√√√√

√√√√ √√√√

√√√√ √√√√ √√√√

√√√√

√√√√ √√√√

√√√√

√√√√ √√√√

√√√√

√√√√

√√√√

√√√√

√√√√

√√√√

√√√√

1

2

2

3

1

Hit othersThrowing

√√√√

√√√√√√√√

√√√√ √√√√

√√√√ 2

l4

l4 Parents also might want to use a structured form. We should develop one for home use. I have examples.lerman, 2/14/2010

10/7/2013

10

Structured A-B-C (Antecedent – Behavior – Consequence) Assessment

None

Teacher walked away

Other activity delayed or removed

xWork requirement/instruction delayed/

removed

Access to food/leisure materials/ activities

xxxAttention, response block, told to “stop”

Immediate consequence:

xNone

Provoked by classmate

xGiven instruction/prompt to work

Other request denied

Leisure material/food removed or denied

xxIgnored by teacher; someone walked away

Immediate antecedent

xHand-biting – placing any part of the hand past

the plane of the lips

xxElopement – attempting to leave designated

area without permission or supervision

Behaviors (List specific problem ):

None

Teacher walked away

Other activity delayed or removed

xWork requirement/instruction delayed/

removed

Access to food/leisure materials/ activities

xxxAttention, response block, told to “stop”

Immediate consequence:

xNone

Provoked by classmate

xGiven instruction/prompt to work

Other request denied

Leisure material/food removed or denied

xxIgnored by teacher; someone walked away

Immediate antecedent

xHand-biting – placing any part of the hand past

the plane of the lips

xxElopement – attempting to leave designated

area without permission or supervision

Behaviors (List specific problem ):School Version

What does the research say about descriptive assessment?

o More objective than indirect assessment

o Correlation does not always mean causation!

o Can be difficult to interpret data

o Results often unclear

What if …….?

-- A-B-C data are unclear (no consistent antecedents & consequences)

-- A-B-C data are clear but treatment is ineffective

Possible next step…….

Step 4: Conduct an Experimental (Functional) Analysis

� Directly manipulate potential antecedents & consequences

� Levels of behavior under one or more “test” conditions are compared to those under a “control” condition

� Originally developed by Brian Iwata as a way to assess self-injurious behavior in adults with developmental disabilities….

10/7/2013

11

Condition Antec Consequence

“Attention”

Test for Positive

Reinforcement

Adult present, but ignores

individual

Adult delivered statement of

concern or verbal reprimand

“Demand”

Test for Negative

Reinforcement

Adult present; work materials

present; adult delivers

instructions

Adult removes instructions

and materials

“Alone”

Test for Automatic

Reinforcement

Adult absent; leisure

materials absent

None

“Play”

Control Condition

Adult present; leisure

materials present; no

instructions; continuous

attention

None

Functional Analysis

Now We Know the Function

Next Step: Function-Based Intervention!

10/7/2013

12

Two Important Intervention Components

Component #1: How to respond to problem behavior so that the maintaining consequence(s) are withheld

Antecedent → Problem Behavior→ Consequence

Component #2: How to teach and maintain an alternative (replacement) behavior

Antecedent → Problem Behavior → Consequence

Replacement Behavior → Consequence

Developing Function-Based Behavior Intervention Plans

Function: Attention or Tangibles

#1: Remove the Consequence

Planned Ignoring (Extinction)

�Withhold attention and tangibles for at least 1 minute after the problem behavior has occurred.

�When problem behavior occurs, do not attend to it. Do not provide access to preferred items in an effort to redirect the individual.

� If problem behavior occurs while interacting with the individual, walk away; do not provide any verbalattention.

o Block or prevent dangerous behavior in a neutral manner if necessary.



#2: Teach An Alternative (Replacement) Behavior

Select a Replacement Behavior That:

� The individual already knows how to do (more efficient than teaching a new behavior)

� Can be easily identified by others (e.g., communication)

�Will naturally produce the consequence that was maintaining problem behavior (How do other people gain access to this reinforcer? By asking for it? By manipulating the environment in some way, such as opening a toy box to get a toy?)

� Is easier to exhibit than challenging behavior

10/7/2013

13




Teaching the Replacement Behavior:

� Develop a plan for teaching the replacement behavior

during instructional sessions and throughout the day

� Use prompts and reinforcement to teach the behavior

� Develop a plan for maintaining the behavior

Teaching the Replacement Behavior

Set up for Practice (Antecedent)

Wait 5-10 Seconds

Model or Physically Guide

to do Response

Provide Consequence

yes

Provide Consequence

No

Individual does behavior

with assistance


Example

Get on the phone

Wait 5-10 Seconds

Take child’s hand and

show him or her how to tap

your shoulder

Provide Attention

Tapped you on

The shoulder

Provide Attention

Did not tap you

on the shoulder

Function: Attention

10/7/2013

14

Example

Place cookie for your learner to see

Wait 5-10 Seconds

Direct your learner to

“Say Cookie”

Give cookie and praise

Says approximation

to cookie

Give cookie and praise

Does not say anything

Learner says “cookie”

Function: Tangibles

Function: Escape

#1: Remove the Consequence

“Escape Extinction”

o Do not permit the individual to escape the task/activity/instruction when problem behavior occurs

o Use a three-step prompt sequence to keep the individual on task:

1.TELL what to do:

• Give clear instruction

2. SHOW what to do:

• Model the exact response OR provide gestures that indicate what you want (e.g., point to chair)

• Restore environment; Say, “now you do it.”

3.HELP do it:

• Take the individual hand-over-hand through entire response and say, “you need to _______.”


Function: Escape


Potential Replacement Behaviors:

Compliance to an instruction

On-task behavior

A known form of communication


Will lead to escape

or a brief break

=

10/7/2013

15

Function: Escape


Teaching the Replacement Behavior:

� Develop a plan for teaching the replacement behavior during relevant situations (when the individual will be motivated to escape or get a break)

� Use prompts and reinforcement to teach the behavior

� Develop a plan for maintaining the behavior


Function: Escape#2: Teach An Alternative (Replacement) Behavior

Say, “Clean up the blocks”

After 5 seconds of following instruction

Take child’s hand and

physically guide her

to hand you card

Provide break

Child gives you

“break” card

Provide a break

Did not give you

“break” card

Example

BREAK

Function: Escape

Other Potential Strategies

� Provide rewards for on-task behavior or instruction-

following:

• Break from task

• Social: praise, hugs, tickles, high-5

• Material: toy, edible, favorite activity

� Intersperse easy or preferred tasks with aversive or

difficult ones

� Permit individual to choose tasks or activities

10/7/2013

16

Function: Sensory Stimulation

#1: Prevent or attenuate the sensory consequences of the behavior

Must identify the potential consequence!

� Does the behavior produce any observable changes in the environment (e.g., banging objects)?

Alter physical environment so that behavior no longer produces the outcome (e.g., cover objects so that they do not make noise).

� Is the behavior limited to body manipulation (e.g., self-injury, stereotypic movements)?

Consider possible adaptive clothing or devices that minimize stimulation produced by the behavior.

Function: Sensory Stimulation

#2: Teach an Alternative (Replacement) Behavior

� Identify strong positive reinforcers (rewards)

� Teach a behavior that is incompatible with problem behavior (e.g., manipulating leisure materials)

� Rotate rewards/activities often and encourage engagement

Effective Interventions

� Require correct implementation

Everyone must know how to follow the plan exactly

� Require consistent implementation

Everyone must follow the plan every time

10/7/2013

17

Potential Issues� Sometimes behavior gets worse before better!

• Keep track so you can see progress over time

(More on this in a moment)

�More effortful to do procedure than to give in

• Remember importance of consistency!

�Might be difficult to implement in some settings

• Plan ahead to prevent problems

� Our behavior is also influenced by consequences

• Reinforcing problem behavior makes it stop now

Good news now, bad news later…

It is a vicious cycle!

Now We Have Designed Our

Function-Based Intervention

Next Step: Measure and Evaluate!

A Good Measurement System Is…..

(1) Objective: Observable, quantifiable, clearly defined behavior

(2) Reliable: Consistent (across time, users)

(3) Accurate/Valid: Provides true representation of behavior &

events

(4) Sensitive: Captures changes in behavior

10/7/2013

18

Identify Best Dimension of Behavior to Measure

• Count/Frequency: # of times behavior occurs

• Duration/speed: Amount of time consumed by behavior

• Latency: Time elapsed to onset of behavior from some

starting point

• Interresponse time (IRT): Amount of time between episodes of

behavior

• Errors: Correctness of behavior

• Topography: Form of behavior

• Strength/intensity: Force of behavior

Choose Your Recording Method and Create Data Sheet

1) Continuous : Behavior observed & recorded throughout

school day or period using either:

(a) Event recording (frequency, rate)

Count each instance of behavior

(b) Timing (duration, latency, IRT)

Count passage of second, minute, or hour from one point

to another

Best for:

Low frequency behavior

Behavior with clear on-set/off-set

Example Tally Mark

Group WorkIIII III

Aggression Hand Raise

Activity

Individual Work

Group Work

Class Work

Transition

Other

Instructions: Throughout the day whenever V.M. has an outburst of aggression or raises his

hand, make a tally on the data sheet.

Aggression: Any instance where V.M. physically hits or attempts to hit, kick, slap, punch, spits

at, or high force pinch another person, including students or staff.

This may also be in the form of an object being used to hit another person.

Hand Raise: Any instance where VM raises his hand above shoulder level.

Date:_____

10/7/2013

19

Time Duration

Disruption

Freq.

Aggression

Freq.

Assignments

Completed

Freq.

Card

Exchange

Freq.

Reinforcers

Earned31 32 33 34 35

36 37 38 39 40

8:30-8:45 41 42 43 44 45

46 47 48 49 50

51 52 53 54 55

8:46-9:00 56 57 58 59 60

1 2 3 4 5

6 7 8 9 10

9:01-9:15 11 12 13 14 15

16 17 18 19 20

21 22 23 24 25

9:16-9:30 26 27 28 29 30

31 32 33 34 35

36 37 38 39 40

9:31-9:45 41 42 43 44 45

46 47 48 49 50

Tracking Multiple Behaviors – Duration and Frequency

2) Time Sampling (Discontinuous Recording)

Provides an estimate of duration or occurrence

• Divide school day or period into smaller intervals

(e.g., 5 minutes, 10 minutes)

• Record presence/absence of behavior during interval

• Determine % of intervals scored

The smaller the interval, the more accurate the data!

Time Sampling Methods

�Whole-interval recording

Score if behavior during ENTIRE interval

Underestimates: Use for behavior increase

� Partial-interval recording

Score if behavior during ANY PORTION of interval

Overestimates: Use for behavior decrease

�Momentary time sampling (MTS)

Scored if behavior AT END (or beginning) of interval

Random error (does not consistently over- or underestim)

Just as accurate as WIR and PIR but easier!!!! (exception: not recommended for low-frequency, short durationbehavior)

10/7/2013

20

Student: __________________ Date:_________________________

Directions: Place a check mark if behavior occurred during the interval

Behaviors: 1)

2)

3)

7:00 -7:10 1:00-1:10

7:10-7:20 1:10-1:20

7:20-7:30 1:20-1:30

7:30-7:40 1:30-1:40

7:40-7:50 1:40-1:50

7:50-8:00 1:50-2:00

8:00-8:10 2:00-2:10

8:10-8:20 2:10-2:20

8:20-8:30 2:20-2:30

8:30-8:40 2:30-2:40

8:40-8:50 2:40-2:50

8:50-9:00 2:50-3:00

9:00-9:10 3:00-3:10

9:10-9:20 3:10-3:20

9:20-9:30 3:20-3:30

9:30-9:40 3:30-3:40

9:40-9:50 3:40-3:50

9:50-10:00 3:50-4:00

10:00-10:10

10:10-10:20 Comments:

10:20-10:30

10:30-10:40

10:40-10:50

10:50-11:00

11:00-11:10

11:10-11:20

11:20-11:30

11:30-11:40

11:40-11:50

11:50-12:00

12:00-12:10

12:10-12:20

12:20-12:30

12:30-12:40

12:40-12:50

12:50-1:00

Interval Recording Sheet

Date:

Shade the time square if John is having a tantrum when the

timer goes off

Tantrum = non-compliance + one other problem

behavior (hitting, kicking, throwing items)

Circle the time square if John is on-task when the timer

goes off

On-task = Joseph is complying with a demand or attempting to

comply

NOT ALL SQUARES WILL HAVE A CIRCLE OR

SHADE

(THERE MAY BE TIMES WHEN JOHN IS NONCOMPLIANT BUT NOT

HAVING A TANTRUM)

8:00 11:10 2:20

8:10 11:20 2:30

8:20 11:30 2:40

8:30 11:40 2:50

8:40 11:50 3:00

8:50 12:00 3:10

9:00 12:10 3:20

9:10 12:20 3:30

9:20 12:30

9:30 12:40

9:40 12:50

9:50 1:00

10:00 1:10

10:10 1:20

10:20 1:30

10:30 1:40

10:40 1:50

10:50 2:00

11:00 2:10

Tracking Multiple BehaviorsUsing MTS

Do I have to Collect Data All Day?!?!?

� Use shorter observation periods for frequent behavior

� Consider where and when behavior is most likely to occur (or

should occur)

� Select a circumscribed period/setting to evaluate intervention

initially

10/7/2013

21

Using Your Data to Evaluate and

Monitor Progress

Don’t forget Baseline!

• Collect data on behavior before you introduce the

behavior plan

• Gives you a point of comparison once you begin

Introduce Intervention

• Continue to collect data

• Use same measurement as baseline

• Graph and compare

Graphs

Visual display of performance over time

Benefits:

� Helps with interpretation of data

� Permits on-going monitoring of behavior

� Allows intervention changes to be made quickly

� Provides feedback to behaver

0

5

10

15

20

25

30

35

40

1/0 1/2 1/4 1/6 1/8 1/10 1/12 1/14 1/16 1/18

Days

Communication TrainingBaseline

Number of Requests

Elements of A Simple Line Graph

10/7/2013

22

0

20

40

60

80

100

120

0 5 10 15 20 25 30

Importance of Continuous Evaluation Benefits of Graphs!

QUESTIONS?

Thank you!

[email protected]

presentation handout [read-only] - tasp.memberclicks.net · pica (eating inedible objects) common...

Documents