Introduction to Applied Behavior Analysis and Positive Behavior Supports

1
Introduction to Applied Behavior Analysis and
Positive Behavior Supports

• Ed Sbardellati, Ph.D.
• Washington County Mental Health
• Sherri Rosenberg, M.A., BCBA
• Washington County Mental Health
• August 19, 2010

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Training Overview

• What Are ABA And PBS?
• A Framework for Understanding Human Behavior
• Basic Elements of Effective Interventions
• Functions of Behavior
• Antecedent-Based Interventions
• Consequence-Based Interventions
• Skill Building
• Data Collection

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What are ABA PBS?
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What is ABA?

• A discipline committed to the understanding and
  improvement of human behavior
• Focuses on objectively defined, observable
  behaviors of social significance
• Seeks to improve behavior while demonstrating
  reliability between applied interventions and the
  noted improvement

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What is ABA?

• The science in which procedures derived from the
  principles of behavior are systematically applied
  to improve socially significant behavior to a
  meaningful degree
• BAER, WOLF AND RISLEY (1968)

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ABA defined (cont.)

• APPLIED
• Refers to the social significance of the behavior
  (of immediate importance to the individual or
  society)
• BEHAVIOR
• Behavior is in need of improvement
• Behavior must be observable and measurable

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ABA defined (cont.)

• ANALYSIS
• Believability
• Demonstrates a functional relationship between
  behavior and intervention
• controls the occurrence and nonoccurrence of a
  behavior

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What is Positive Behavior Support?

• A set of research-based strategies used to
  increase quality of life and decrease problem
  behavior by teaching new skills and making
  changes in a person's environment

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PBS combines

• Valued Outcomes
• Behavioral and Biomedical Science
• Validated Procedures
• Systems change to enhance quality of life and
  reduce problem behaviors

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Human Behavior
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Behavior

• is the movement of an organism or of its parts
  in a frame of reference provided by the organism
  or by various external objects or field
• 
  (Cooper et al, 2008)

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Behavior

• Human Behavior
• Behavior is LEARNED
• Behavior is a function of the environment

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Assumptions of ABA

• BEHAVIOR IS LEARNED
• B(F)E
• New behaviors can be taught
• Old behaviors can be unlearned

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Assumptions of ABA

• We change behavior by changing the ENVIRONMENT

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Behavior

• Overt
• An action that can be observed and recorded by a
  person other than the one engaging in the
  behavior
• Must pass the Dead Mans Test

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Behavior

• Covert
• An action that can NOT be observed and recorded
  by a person other than the one engaging in the
  behavior
• Private events
• ABA predominantly addresses overt behaviors
• Cognitive-Behavior Modification addresses covert
  behaviors

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Key Terms Concepts

• Stimulus
• An environmental event that can be detected by
  one of the senses
• Is any condition, event, or change in the
  physical world

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Key Terms and Concepts

• Response
• One instance or occurrence of a particular
  behavior
• A specific instance of a particular behavior
• Are the focus of observation and measurement in
  behavioral studies
• Is the measurable unit of analysis in the science
  of behavior

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Stimulus Control

• Stimulus Control
• Increased probability that a behavior will occur
  in the presence of certain environmental
  conditions
• If a principal yells
• If a police officer approaches
• If a telephone rings

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Consequence

• EEffects only future behavior
• RResults in an increase, decrease or no effect on
  behavior
• The probability that similar responses will be
  emitted under future similar stimulus conditions

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Respondent Behavior

• NNO LEARNING REQUIRED
• It is a reflex
• RRespond INVOLUNTARILY to certain stimuli

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Operant Behavior

• Is VOLUNTARY
• IInfluenced by the antecedents and consequences
  surrounding the behavior

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Operant Behavior
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Three Term Contingency

• Reinforcement
• Cue----------R----------C
• Reductive Procedures
• Cue----------R----------C-

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Reinforcement

• When a stimulus change immediately follows a
  response and increases the future frequency of
  that type of behavior in similar conditions

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Reductive Consequence

• When a stimulus change immediately follows a
  response and decreases the future frequency of
  that type of behavior in similar conditions

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Present Stimulus () Withdraw Stimulus (-)
behavior Positive Reinforcement Negative Reinforcement
behavior Positive Reductive Consequence Negative Reductive Consequence
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Complexity of Human Behavior

• Huge range of behaviors
• Competing contingencies
• Go out on the town or Study for the exam?
• Single event has multiple effects
• Reduce behavior
• Increase behavior
• Escape
• Response chains

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Complexity of Human Behavior

• Complexity of Controlling Variables
• Environmental constructs are complex
• Multiple causation
• Setting events

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Complexity of Human Behavior

• Individual Differences
• Different responses to the same environmental
  conditions
• NO two people experience the world in the same
  way
• Histories of reinforcement
• Individual motor sensory deficits

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Reinforcer Assessment

• Activity

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Framework for Treatment
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Basic Elements of Effective Interventions

• PROACTIVE
• Modify the environment
• EDUCATIVE
• Teach pro-social behaviors and social skills
  which are alternatives to challenging behaviors
• FUNCTIONAL
• Manage consequences of behavior

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Why Bother?

• Strong theoretical and empirical support for
  behavioral procedures
• 40 years of research in behavior change with
  people behavioral and developmental disorders
  autism
• Particularly in the areas of Functional
  Behavioral Assessment and positive approaches to
  behavior change

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Why?

• The use of the Positive Behavioral Supports
  model is becoming more and more widespread as
  reactive approaches have not proven uniformly
  successful

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Reactive Approaches

• PUNISHMENT
• May teach what not to do, but not what to do
• May punish the child, but may not actually reduce
  the behavior in the natural environment

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Reactive Approaches (cont.)

• EXCLUSION
• May address an immediate need, but reduces the
  childs opportunity to learn how to successfully
  interact with the natural environment

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So lets talk some more
about positive approaches
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Proactive

• Modifying the environment to reduce the
  probability that the challenging behaviors will
  occur
• Requires assessment to identify the mismatch
  between the child and the environment
• Can involve a myriad of possible interventions

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May Involve a VARIETY of Interventions

• Changes in settings and situations in which the
  behavior occurs
• Alter or eliminate setting events associated with
  challenging behaviors
• Identify and address precursor behaviors
  associated with challenging behaviors

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Proactive Interventions (cont.)

• Make instructional or curricular changes
• Establishing predictable routines or changing
  expectations
• Increase opportunities for making choices,
  exerting personal control

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Skill Building

• Specifically teach behaviors and skills which are
  functional alternatives to challenging behaviors
  
• Behaviors may be in the learners repertoire or
  may have to be shaped over time

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Functional

• Developing management procedures which address
  the functions of behavior
• Manage consequences such that pro-social
  behaviors are increased and challenging behaviors
  are reduced

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Focus On Behavior

• We need to clearly define the behavior(s) we want
  to increase or decrease
• Identify the pro-social skill(s) we want to teach
  as a replacement behavior(s)
• Include these pro-social skills or behaviors in
  the learners individualized behavior change plan

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Focus on Behavior (cont.)

• Focus procedures (like a laser beam) on the
  behaviors we want to increase and decrease
• Carry out procedures consistently over time and
  across staff

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Focus on Behavior (cont.)

• Evaluate effects of procedures on chosen
  behaviors
• Daily data collection
• Revise procedures as necessary

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Functions of Behavior

• A note on behavior
• Abruscatos Second Law

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A Note on Behavior

• Our behavior is related to and governed by its
  context
• Can be interpreted as being functional, often
  communicative, purposeful and meaningful for the
  person
• Can be affected by internal events
• physiological conditions and emotional states

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A Note on Behavior (cont.)

• Is affected by factors outside the immediate
  context, including relationships, activity
  patterns and lifestyle issues
• Behavior changes as people mature and develop new
  competencies

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Abruscatos SECOND LAW

• All behavior is rationale to
• the person doing it.
• 
  Abruscato (1973)

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Functions of Behavior
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Functions of Behavior

• FUNCTION
• The reason why problematic behavior continues to
  occur
• SOCIAL FUNCTION
• Environmental events that maintain behavior
• Treatment is based upon identified function, not
  on topography

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Events Which Maintain Behavior

• Positive Reinforcement
• Gaining social attention, preferred items or
  activities
• Negative Reinforcement
• An escape or avoidance function
• Automatic Reinforcement
• Not socially mediated

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Functions of Behavior

• Demand (Avoidance/Escape)
• Attention (Positive and/or Negative)
• Tangible (Access to HPAS/Rewards)
• Automatic Reinforcement (Alone)
• Multiple Factors

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Demand (Avoid or Escape)

• Activities
• Interactions
• People
• Cues or directions
• Environmental stressors, events and situations we
  find aversive

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Obtain Attention from Others

• Positive Attention
• Negative Attention

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Obtain Activity or Object

• Toy
• Computer
• Swings

• Go outside
• Etc.

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Automatic (Self-Reinforcement)

• Behaviors not mediated by the environment
• Examples
• Twirling hair
• Spinning
• Vocalizations (video talk)

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Functions May Come In Pairs

• Examples
• Avoid and get attention
• Avoid and obtain preferred activity

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Multiple Functions

• Some behaviors may serve multiple functions to
  the individual
• Self-injurious behavior
• Noncompliance

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LETS PLAY!

• Name That Function

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Example 1

• Student really dislikes math he feels he is not
  good at it
• Math lesson begins
• Student swears at teacher
• Student is sent out of the room

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Example 2

• Client often vocalizes Disney songs when not
  engaged
• Client is in direct 11 instruction
• Client vocalizes songs to self which makes it
  difficult for his instructor to obtain his
  attention and cue responding

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Example 3

• Student always gets disruptive when spelling is
  cued
• makes loud noises, gets out of seat, argues with
  the teacher
• Student gets to use computer during spelling

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Example 4

• Student likes to be the center of attention
• Student asks an off task, but somewhat
  interesting, question
• Teacher has a conversation with the student about
  the question

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Example 5

• Student enters room when an activity was in
  progress
• Student runs around the room, yells and touches
  other student
• Teacher tries to redirect the student
• Other student grabs the student and they wrestle
• Student is physically removed from the room

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Name That Function

• Home Community Edition

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Example 1

• Dad leaves for work every morning at 730
• Child cries
• loud and long
• Dad remains and consoles child, finally leaves
• Mom tries to engage child in drawing
• preferred activity

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Example 2

• Child is playing with preferred toy
• Other child starts to play with toy
• First child slaps second child
• Second child cries and leaves
• Adult hugs first child

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Example 3

• Child is sitting on the floor and raises hands
  and says up
• Adult doesnt notice and continues conversation
• Child bangs head on floor
• Adult picks up child

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Example 4

• Child is playing on floor, it is time to go to
  school
• Parent approaches with clothing
• Child cries and runs away
• Parent stands with clothing and feels like crying

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Example 5

• Time to get ready for bed
• Dad asks child to go to the bathroom to brush
  teeth
• Child cries and runs away
• Dad asks mom to take over

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Example 6

• Child wakes up in the middle of the night
• Child comes to parents bed and climbs in
• Parents make room and hope everyone gets some
  sleep

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Functions of Behavior

• Demand
• Avoidance/escape
• Attention
• Positive and/or negative
• Tangible
• Access to HPAs/rewards
• Automatic reinforcement
• Alone
• Multiple factors

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Antecedent Control Measures
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Antecedent Control Measures

• Eliminate the cue for the problem behavior
• Provide cues for alternative prosocial behavior
• Reduce the motivation for the reinforcer
  maintaining the challenging behavior
• Increase the motivation for the reinforcer
  maintaining the alternative, more desireable
  behavior
• Increase the response effort for the problem
  behavior

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Antecedent Control Measures

• Decrease response effort for alternative behavior
• Modify the environment to increase the
  consistency and predictability of expectations
• Schedules
• Maximize opportunities for choice and control
• Clear, concise expectations
• Modify curriculum/expectations to maximize
  independent success

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Antecedent Techniques

• Cueing Procedures
• Obtain attention first
• State cue/direction using only a few words known
  to be within clients repertoire
• Wait for client to respond-- avoid repetitive
  verbal cues
• Monitor cooperation
• Praise/reinforce cooperation

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Antecedent Techniques

• Visual Prompts
• Daily picture/icon/written schedule
• Cue cards (portable/stationary)
• In advance of transitions
• In advance of novel situations
• Advance review of expectations, consequences

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Antecedent Techniques

• Advance Verbal Cues/Rehearsal
• With or without visual prompts
• Examples
• Novel activities
• Difficult social interactions
• Ending a preferred activity
• Transitions
• Where, what, reinforcement

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Antecedent Techniques

• Interruption
• As response to low level challenging behaviors
  or precursors
• Interrupt
• Redirect
• Reinforce

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Antecedent Techniques Self-Relaxation
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Self-Relaxation

• Implement in regular training, at precursor level
  and/or after an incident.
• Some portable techniques
• Walking quietly
• Deep breathing (diaphragmatic breathing)
• Muscle tension and relaxation exercises
• Attention focusing exercises

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Other Proactive Techniques to Consider

• Remove or modify a problem event
• Intersperse easy or pleasant activities with more
  difficult or unpleasant activities
• Reduce the impact of negative events
• Allow temporary avoidance /reduce demands
• Add events that promote appropriate behavior

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Consequences
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A Note On Consequences

• Natural consequences
• Logical consequences
• Contrived consequences

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Why Use Reinforcement?

• To build prosocial behavior
• To reduce challenging behaviors

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Underlying Assumptions

• Behavior is learned
• New behaviors can be taught
• Old behaviors can be unlearned

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Underlying Assumptions

• Consequences are defined by their effect upon
  behavior
• We change behavior by changing the environment

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Reinforcement

• A behavior is followed by an event (consequence)
  which serves to strengthen the behavior
• Increases the probability of the behavior
  occurring again

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Reinforcement

• Types of Reinforcement
• Positive reinforcement
• Obtain a reward
• Negative reinforcement
• Avoid an aversive event

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Types of Reinforcers

• Social
• Activity
• Token/Symbolic

• Tangible
• Edible/Drink
• Premack Principle
• Grandmas Rule

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Increasing the Effectiveness of Reinforcement

• Contingency
• Immediacy
• Power
• Schedule or Timing of Reinforcement
• Deprivation vs. Satiation

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Building Behavioral Momentum

• Layering Of Reinforcement
• Immediately
• Throughout The Day
• End Of Day
• Throughout The Week

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A Simple Example

• BehaviorTalking out in class
• Present ReinforcerAttention
• Prosocial SkillsRaising hand to obtain attention

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A Simple Example (cont.)

• Reinforcement
• Immediate
• Call on child when hand is raised, specific
  praise
• Throughout the day
• Stars on chart for raising hand to get attention
  or
• Sticker on chart after classes in which hand
  raising happens, specific praise

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A Simple Example (cont.)

• Reinforcement (cont.)
• Throughout/End of day
• Activity reward/privilege for earning a specific
  number of stars
• End of week
• Bigger activity reward for having a good week

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Building Behavior

• Differential Reinforcement
• Consistently reinforce alternative or
  incompatible behaviors while withholding
  reinforcement for problematic behaviors

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Differential Reinforcement

• Two Simultaneous Procedures
• Reinforcement of prosocial behavior
• Withholding of reinforcement for challenging
  behavior

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Differential Reinforcement

• As a Natural Process of Teaching
• Consistently reinforce (attend to) prosocial
  behavior while withholding reinforcement for
  problematic behavior

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Omission Training (DRO)

• Omission Training is a reductive technique
  wherein we reinforce the absence of a targeted
  behavior at the end of a specified interval of
  time
• First Line of Defense against aggressive
  behaviors

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Systematic Reinforcement of Alternative or
Incompatible Behaviors

• DRA/DRI
• A procedure in which one or more specified
  desirable behaviors, which are alternative or
  incompatible with the targeted behavior
  (maladaptive behavior) are systematically
  reinforced
• The desired effect is to increase these
  alternative or incompatible behaviors while the
  problematic behaviors will reduce

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Behavioral Checklists

• A useful procedure to focus feedback on targeted
  behaviors and skills to increase
• Create a grid or checklist
• Interval based
• 5 minutes to the end of an activity

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James Really Cool Chart ?
ACTIVITY I Was Where I Was Supposed To Be I Only Used Gentle Touch I Worked Hard
CIRCLE
JOURNAL
MATH
SNACK
SPEECH
LUNCH
RECESS
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Skills To Address

• Identify the Behaviors/Skills to be taught or
  increased
• Usually 1-3 behaviors/skills based upon the
  learners age and/or developmental level

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When To Provide Feedback?

• Determine when the checklist will be completed
• More feedback is usually better than less
  feedback
• Provide feedback at certain times of day and/or
• Provide feedback when certain tasks or activities
  are completed

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Symbols/Praise

• Determine what symbols/words will be used to
  provide feedback
• Age appropriateness
• Learners choice
• Always praise the learner when s/he earns
  positive feedback
• Be specific and enthusiastic

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Be Consistent

• In which behaviors/skills we are reinforcing
• In providing reinforcement regularly across the
  day
• Predetermined schedule

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Back Up Reinforcers

• Negotiate the reinforcers the learner will earn
  for being successful
• Privileges/ freedom
• Preferred activities
• Tangible items

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Set Reasonable Objectives

• Start at a lower level to ensure success
• Slowly raise the expectation as the learner
  progresses

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Cash In Frequently

• At least daily for older learners
• Multiple times per day for younger learners

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Delayed Reinforcers

• Be sure to include delayed reinforcers for
  improved behavior over time
• End of day
• Weekly or Bi-weekly

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Evaluation

• Save behavioral checklists for subsequent
  evaluation
• Item and error analysis
• Adjusting the criterion for reinforcement
• Fading the checklist

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ACTIVITY I WAS WHERE I WAS SUPPOSED TO BE I ONLY USED GENTLE TOUCH I WORKED HARD
CIRCLE
JOURNAL
MATH
SNACK
SPEECH
LUNCH
RECESS
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Reductive Procedures

• Extinction
• Response Cost
• Time Out from Positive Reinforcement

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Extinction

• Contingent removal of reinforcement leading to
  the nonoccurrence of the behavior
• A necessary component of behavioral treatment

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Extinction (cont.)

• Extinction Burst
• Not a conscious process
• May include novel or emotional behaviors
• Spontaneous Recovery

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Response Cost

• A reductive consequence that involves a loss of a
  specific reward or a specific amount of a reward

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Increasing the Effectiveness of Response Cost

• Must be a predictable reinforcement system
• Identify (in advance) the behaviors which will
  result in the loss of reinforcement
• Identify (in advance) the reinforcers or amount
  of reinforcement which will be lost

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Response Cost (cont.)

• Provide no more than one warning
• Reduce conversation when using response cost
• Do not escalate consequences or get involved in
  an argument with the learner

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Response Cost (cont.)

• Do not remove reinforcers until they have been
  earned
• If using points or tokens-never go below zero
• Be consistent
• over time
• across settings
• across adults

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Time Out From Positive Reinforcement

• First Question
• Is it?
• Time away from positive reinforcement or
• Escape from the activity

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Time Out From Positive Reinforcement (cont.)

• Second Question
• Is there a better way to manage this behavior?

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Time Out

• Contingent loss of access to reinforcement
• Should result in a decrease in the behavior
  which led to time out

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Types of Time Out From Positive
Reinforcement

• Observational
• Exclusionary
• Seclusionary

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Important Aspects Of Time Out

• Discrepancy between time in in the natural
  setting and time out setting
• The time in environment must be more
  reinforcing
• Consider environmental enrichment or increased
  reinforcement

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Time Out (cont.)

• Time out works best when
• We focus upon one behavior
• It is consistently used
• No attention or other reinforcement is provided
  in time out

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Time Out (cont.)

• We assure that time out is appropriate for the
  learners age or developmental level and
  addresses the identified function of the behavior
  
• We have a consistent exit criterion
• Learner learns what s/he must do to leave time
  out

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Time Out (cont.)

• Consider teaching self-relaxation/self-calming as
  part of the exit criterion

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TIME OUT ROOM DISADVANTAGES

• STUDENT MAY PHYSICALLY RESIST MOVING TO THE TIME
  OUT ROOM
• ELIMINATES THE STUDENTS ACCESS TO ONGOING
  INSTRUCTION
• STUDENT MAY ENGAGE IN BEHAVIORS WHICH ARE UNSAFE
  IN TIME OUT (E.G., SIB) OR ARE REINFORCING
  (SELF-STIMULATION) OR NOVEL, MORE ESCALATED
  BEHAVIORS
• SOCIAL STIGMA

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Skill Building
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Before you start

• Ask two questions
• What am I going to teach?
• How am I going to teach it?

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Fair Pair Rule

• For every behavior identified for reduction, a
  functional replacement behavior must be taught

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What to Teach?

• Activity
• Five behaviors for group activities
• Aggression maintained by obtaining reinforcement
• Work refusal maintained by escape and attention
• Noncompliance with directions maintained by
  escape
• Interrupting maintained by attention
• Bolting maintained by escape

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Some Alternative Skills To Teach

• On Task
• Following class routine
• Work completion
• Making eye contact
• Following directions
• Gentle hands
• Polite words
• Self-calming
• Taking good time-outs

• Friendship skills
• Complementing others
• Greeting others
• Asking for help
• Manding
• Personal space/boundaries
• Specific problem solving skills

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ACTIVITY Selecting Alternative Behaviors

• Organize groups
• Assign behaviors to groups
• Find a volunteer with real life example
• Discuss behavior and context
• Identify alternative skills to teach

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How to Teach

• Considerations
• Learning strengths challenges, for example
• Language (receptive and expressive)
• Imitation, Discrimination
• Social Skills
• Learning history
• Reinforcement history
• Topography of the skill
• Functional context
• HIGHLY INDIVIDUALIZED

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Behavior Change Procedures

• Shaping
• Task analysis
• Chaining
• Prompting
• Prompt Fading
• Evaluation of procedural effectiveness

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Shaping

• The differential reinforcement of successive
  approximations of the same behavior
• Small step learning
• Success oriented
• If unsuccessful, its us, not them!

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Shaping

• Define target behavior
• Do you need to shape this behavior?
• Identify the starting behavior
• Determine the shaping steps
• Choose reinforcers
• Differentially reinforce each successive
  approximation
• Move through the steps at a proper pace
• Be prepared to move backwards

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Shaping of Problem Behavior

• Shifting topographies of behavior
• Accidental shaping/Accidental reinforcement
• How do we do this?
• Prompting
• Fading
• Reinforcement
• Extinction

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Shaping Example

• For example, John never does his math homework.
  You would like to have him complete his homework
  on a daily basis.  You realize that if you wait
  for him to complete his homework before you
  reinforce him in some way, you may never (or
  infrequently) have the opportunity to administer
  a positive consequence.

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Shaping Example

• John will write his name at the top of the
  worksheet.
• John will complete one problem of his choice.
• John will complete five problems of his choice.
• John will complete either all the odd numbered
  problems or all the even numbered problems.
• John will complete all problems except one.
• John will complete all problems.

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Task Analysis

• Breaking a complex skill or series of behaviors
  into smaller, teachable units
• The product of a task analysis is a series of
  sequentially ordered steps or tasks

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Constructing a Task Analysis

• The sequence of behaviors that one individual may
  use to perform skill may not be the same as
  another individual
• Must be individualized according to
• Age
• Skill level
• Prior experience
• Some task analyses have a limited number of
  steps, but these steps may be broken down into
  subtasks

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Constructing a Task Analysis

• Methods
• Observe a competent individual perform the task
• Consult with an expert or persons skilled in
  performing the task
• Perform the behavior yourself
• Systematic trial error procedure
• Initial task analysis is generated
• Can refine it as you use it, if necessary

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Task Analysis Example

• Brushing Teeth
• Pick up the tooth brush
• Wet the brush
• Take the cap off the tube
• Put paste on the brush
• Brush the outside of the bottom row of teeth
• Brush the outside of the top row of teeth
• Brush the biting surface of the top row of teeth
• Brush the biting surface of the bottom row of
  teeth
• Brush the inside surface of the bottom row of
  teeth

• Brush the inside surface of the top row of teeth
• Brush the front surface of the bottom and top
  rows
• Spit
• Rinse the brush
• Replace the brush in the holder
• Grasp cup
• Fill cup with water
• Rinse teeth with water
• Spit
• Replace cup in holder
• Wipe mouth
• Screw cap back on tube

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Prompting

• Stimuli provided before or during a behavior to
  facilitate the performance of the behavior to
  access reinforcement

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Fading

• Transferring stimulus control from the prompt to
  the SD
• Gradual removal of prompts until the behaviors
  occurs in the presence of the SD without prompts

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Types of Prompting

• Response Prompts
• Modeling/Imitation
• Verbal Prompts
• Gestural Prompts
• Visual Prompts
• Physical Prompts
• Partial
• Full

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Types of Prompting

• Stimulus Prompts
• Involves change in the stimulus
• Positional prompts
• Within stimulus prompts
• Change the salience of the SD
• Size, shape, color, intensity
• A versus B
• Extra stimulus prompt
• Adding a stimulus

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Prompt Delay/Time Delay

• Time Delay Procedure
• Present the Sd
• Wait a certain number of seconds
• If the correct response is not made, prompt the
  response
• The time delay may be consistent or it may be
  faded over attempts/prompts/Sds

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Stimulus Control

• Training/teaching is not complete until we
  eliminate prompts and the behavior occurs at the
  right time and without assistance
• Avoid prompt dependency

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Prompt Fading

• Gradual removal of a response prompt over time
  until the use of the prompt is eliminated

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Prompting Options

• Graduated Guidance
• Guiding performance with hands
• visual prompts
• Verbal cues
• Least to Most Method
• Least amount of assistance each opportunity
• Most to Least Method
• Guide individual through entire sequence and
  gradually fade assistance

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Prompt Fading

• Consequences to gradual changes in form,
  position, or intensity

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Prompt Fading

• Prompt Delay/Time Delay
• Constant Prompt Delay
• Graduated/Progressive Prompt Delay
• Be prepared to back up to previous steps

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Stimulus Fading

• Removal of a stimulus prompt

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Using Prompting and Transfer of Stimulus Control

• Determine Cant do. vs. Wont do.
• Ability vs. Compliance
• Choose the most appropriate prompting strategy
• Get the learners attention
• Present the SD
• Prompt the correct response
• Reinforce correct behavior
• Transfer stimulus control

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Evaluation

• Before you end a program or terminate a protocol,
  ask yourself
• How well have I taught the skill?
• Your data should tell you!

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Putting It All Together-Picking

• Proactive/Preventative
• Measures
• Keep student well hydrated
• Keep nails trimmed
• Apply lotions several times per day

• Behavior Management
• If bx occurs, redirect
• If bx occurs again, redirect
• No points for interval
• If bx occurs again, band-aid

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Putting It All Together-Picking

• Instruction
• Nail care
• Visuals as a flip chart and checklist
• Measures include independence duration of task
• Physical modification of care materials

• Reinforcement
• Point system for the occurrence of positive
  behaviors
• Safe body
• Following directions
• Nice words
• Doing your work

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Data Collection
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Data Collection

• Functional Behavioral Assessment
• The process of obtaining information on events
  which precede and follow a behavior to determine
  which antecedents and consequences are reliably
  associated with the occurrence and nonoccurrence
  of the behavior

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How To Conduct An FBA

• ABC Assessment
• Descriptive Analysis (aka Direct Assessment)
• Structured interview/checklists with parents and
  other caregivers (aka Indirect Assessment)
• Functional Analysis
• Experimental approach using analog conditions

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FBA (cont.)

• ALWAYS conduct a functional assessment before
  developing a treatment plan for a child with
  seriously challenging behaviors

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FBA

• Descriptive Analysis
• Descriptive Analysis refers to the process of
  obtaining direct and daily information concerning
  the context of challenging behavior
• Usually done through ABC analysis

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A-B-C (Operant Behavior)
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ABC Data

• Antecedent
• Events or interactions that happen before the
  behavior occurs immediate or delayed/internal or
  external
• Behavior
• The behavior or sequence of behavior which
  occurred
• Consequence
• Events/interactions which happen after the
  behavior what one gets and what one avoids

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Functional Behavioral Assessment The ABCS

• Antecedent
• Immediate/Delayed
• Medical
• Physiological
• Environmental
• Interactional
• Personal/Control

Behavior What a person says or does
Consequence Social Attention Tangible Activity Esc
ape Avoidance Combinations
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Information Gained Through a FBA

• Describe the problem behavior
• Identify the antecedents to the behavior
• Identify the consequences of the behavior
• Consider alternative behaviors to teach
• Develop hypotheses regarding the occurrence of
  the behavior
• Identify potential reinforcers
• Describe previous interventions used

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Data Collection

• Direct And Daily Data
• Clearly define the behavior we are measuring
• Operational Definition
• a clear description of the behavior which is
  written in simple, lay terms such that anyone can
  determine if the behavior did or did not occur

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Quantitative Measures

• Frequency
• Tallies of the total number of behaviors which
  occurred or the number of incidents of behavior
  which occurred in a specified time period

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Quantitative Measures

• Duration
• The elapsed time a behavior occurred

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Quantitative Measures

• Intensity
• Descriptions or ratings of the severity of
  behavior
• Can focus upon
• the number of behaviors within an incident and/or
  
• the duration of the incident and/or
• specific Likert-type scale or checklist

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Interval Recording

• Coding the presence or absence of a specific
  behavior during a predetermined time
  period-i.e., whole, partial, momentary
• May include frequencies of behavior within an
  interval or measures of the rate of the behavior

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Activities

• How would you measure THIS behavior?
• Video data collection

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Interobserver Agreement (IOA)

• A measure of validity
• Multiple calculations
• This is TOTAL COUNT IOA
• Total of agreements
• ____________________________ X 100
• Total of agreements disagreements

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IOA Example-Swearing

• Observer 1
• 7 instances of swearing

• Observer 2
• 9 instances of swearing

of Agreements7 of Disagreements2 IOA 7
gt 7 gt .77 X 10077 72 9
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Graphic Displays

• Use of line, bar or pie graphs to describe the
  occurrence of a behavior over time or the
  proportions of behavior
• Very helpful in evaluating the effectiveness of a
  treatment procedure and in determining when to
  change a procedure

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Ethics
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Ethics

• Definition
• The discipline dealing with what is good and bad
  and with moral duty and obligation
• A theory or system of moral values
• The principles of conduct governing and
  individual or group

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Americans with Disabilities Act

• The Congress finds that physical or mental
  disabilities in no way diminish a persons right
  to fully participate in society

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Special Education

• Basic Rights
• Services are free to parents under the federal
  law Individuals with Disabilities Education Act
  (IDEA) and its regulations
• Each state has special education laws and
  regulations that govern special educations
  services

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Confidentiality

• FERPA
• Family Educational and Rights to Privacy Act
• Protects the privacy of student education records
  and applies to all schools that receive funds
  under an applicable program of the U.S.
  Department of Education

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Confidentiality

• HIPAA
• The Health Insurance Portability and
  Accountability Act of 1996 (HIPAA) Privacy Rule 
• The Privacy Rule provides federal protections for
  personal health information held by covered
  entities and gives patients an array of rights
  with respect to that information and permits the
  disclosure of personal health information needed
  for patient care and other important purposes
• http//www.hhs.gov/ocr/privacy/index.html

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Least Restrictive Environment

• Individuals with Disabilities Education Act
• Opportunity to be educated with non-disabled
  peers, to the greatest extent possible
• Access to the general education curriculum,
  extracurricular activities or any other program
  that non-disabled peers would be able to access

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Least Restrictive Environment

• Should be provided with supplementary aids and
  services necessary to achieve their educational
  goals if placed in a setting with non-disabled
  peers
• Generally, the less opportunity a student has to
  interact and learn with non-disabled peers, the
  more that the setting is considered to be
  restricted

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Right to Least Restrictive Intervention

• Least Restrictive, Most Effective
• Consider lesser intense interventions if it is
  believed meaningful behavior change can be
  obtained

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Related Websites

• http//apbs.org/whatsnew.htmlstandards_of_practic
  e
• http//www.bacb.com
• http//www.ed.gov/policy/gen/guid/fpco/ferpa/index
  .ht
• http//www.hhs.gov/ocr/privacy/index.html

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THANK YOU AND GOOD NIGHT