Functional Behavior Assessment to Advance Quality of Lives

1. Functional Behavior Assessment to Advance Quality of Lives Michael Benjamin May, Ed. D, LPC, BCBA, NADD-CC

2. Agenda Review terms Reinforcement Data collection Rating scales Formal FBA Interview Protocol Functional Analysis Vignette Progress monitoring Questions

3. FBA Terms Review of Terms This Photo by Unknown Author is licensed under CC BY-NC-SA

4. What is a Behavior Behavior is any action “Dead Man (Person) Rule-” If a corpse can do it, it is not a behavior

5. Superman Statue I don’t like the “Dead Man (person) Rule” If the Superman Statue can do it, it is not a behavior

6. behavioral Definition (what does it look like) Describe behaviors (behavioral definitions) in terms that are “repeatable, observable, and measurable (Alberto & Troutman, 1999, p. 60)” I usually tell my staff…..Good behavioral definitions would allow anyone off the street to identify its occurrence

7. Words to avoid when developing behavioral definitions Intention (with the purpose of) Inappropriate Refusing Not doing

8. When is a behavior, maladaptive? Maladaptive behaviors negatively impact quality of life, thus are targeted to be changed “Practitioners must select behaviors to change that are socially significant for participants (individuals): social, language, daily living, self-care, vocational, and/or recreation of leisure behaviors that improve day-to-day life experiences (Cooper, Heron, & Heward, 2007, p. 16)”

9. “So What Test” Reminder Let’s not hold the individuals we serve to a standard that is unrealistic or does not reflect a desired every day life. Examples: -Bill cursed at me when I accidently changed the station when he was watching an Eagles game -Jill laughs loudly and makes a noise that sounds like “shut up”-While on a trip to Atlantic City, Lisa danced with a random guy

10. How do we measure a maladaptive behaviors Count (including interval data for high frequency behaviors) Rate Duration Latency IRT

11. More Terms Topography Function Establishing Operation (EO) Discriminative Stimulus (SD)

12. They are not the same…………. EO and SD Reminder: SD Are related to the differential availability of the reinforcement EO relates to the effectiveness of a particular reinforcement

13. Topography vs Function Topography Response Class Function Response Class Vs

14. Reinforcement

15. Reinforcement Positive Reinforcement Negative Reinforcement This Photo by Unknown Author is licensed under CC BY-SA This Photo by Unknown Author is licensed under CC BY-SA

16. Reminder Negative Reinforcement Punishment Is Not

17. Positive Reinforcement types Social Positive Reinforcement (Attention) Tangible Reinforcement Automatic Positive Reinforcement

18. Negative Reinforcement Social Negative Reinforcement Escape Demands Automatic Negative Reinforcement

19. REINFORCER? Giving a bag of M & M’s to a child who cleaned his room, is a reinforcer?

20. Great way to teach behavior function to DSP’s, who may not have a behavioral background S-SensoryE-EscapeA-AttentionT-Tangible

21. Review terms Antecedent Setting Events Vs

22. Assessing the Behavior Functional Behavior Assessment (FBA)-Identifies the reinforcing results maintaining a behavior FBA

23. FBA Observations Formal Interview Protocols Functional Analysis

24. Reminder: Before we implement any behavioral interventions, we must rule out All potential medical causes

25. Observation When completing an observation, record the following: -All the people -All activities that were being implemented -Every behavior demonstrated -Record everything done or said to the individual

26. Analyzing the Observation If don’t know, leave blank

27. Analyzing the Observation You Observed: You enter at 9PM, and Joe is sitting on the sofa. There is a peer sitting next to him. The DSP is sitting on the chair next to the sofa. Joe, his peer, and DSP are all facing towards the TV. At 9:02PM, Joe’s peer picks up the remote and shuts off the TV. Joe starts to hit himself on the head with an open palm. The DSP walks over to Joe’s peer, takes the remote out of his hand, and turns on the TV. Joe puts his hands in his pockets

29. SCENARIO Let’s try this together

30. You observe: *Prior to entering the program area, you are informed that today is Johnny’s instructor’s first day At noon, you arrive at the workshop. Johnny is sitting at a table with his head facing towards the window. There are work materials (bags and pencils) on Johnny’s table. Johnny’s hands are in his pockets. Six other individuals are in the workshop. All six individuals are completing piece work. There is also one instructor who is next to one of Johnny’s peers.

31. You observe: At 12:08PM, the instructor walks to Johnny’s table, and says to Johnny “Show me how nice you work.” Johnny takes his hands out of his pockets and picks up two pencils in his left hand and places them in a bag. The instructor says “great job.” Johnny picks up another pencil and places it in a bag. The instructor walks away from Johnny. Johnny put his hands in his pockets and looks towards the window.

32. ABC Data

33. ), DSP’s collect the best data!!!!! DSP’s must be empowered and we must communicate their importance in treatment programming If they don’t know, teach them about behavioral interventions -Behavior Function-Data Collection Develop simple data sheets for DSP’s that limit extra work

34. ABC Data

35. What’s the assumed function?

36. Bar Graph Results of DSP’s data pertaining to what’s happening before the TB Assumed Function? And what could we do

37. Questions you may ask to identify function

38. Indirect FBA Formal interview protocols Rating scales

39. Rating Scale ExamplesMotivation Assessment Scale (MAS) Motivation Assessment Scale II (MAS-II) Functional Assessment Screening Tool (FAST) Questions About Behavioral Function (QABF)

40. Rating Scale needs Paired with other data collection methods Multiple staff interview You may need to modify the wording or provide examples

41. Make sure the staff understands the question MAS question #10 “Does this person seem to do the behavior to upset or annoy you when you are trying to get him/her to do what you ask?” Staff: “Always, I get so upset when he screams. I usually just leave him alone.”Clinician: “So, he does scream even if you are not asking him to do anything?”Staff: “Yes, I never ask him to do anything. He just screams. There are times when he is not screaming, and he will do whatever you ask him to do.”Clinician: “So, if he is not screaming and you ask him to do a chore, would he start screaming?”Staff: “No, he would just do the chore.”

42. Formal Interview Protocol A FBA interview protocol must answer the following questions:-What’s the maladaptive behavior - When is it demonstrated -Assumed function

43. Functional Behavior Assessment Questionnaire -This tool provides guidelines for treatment planning -Completed during an interdisciplinary treatment team meeting -Takes about 30-60 minutes to complete -Question 1-19 usually used for orientation -Question 20-24 answered during a future meeting

44. Functional Behavior Assessment Questionaire Rule out medical concerns Dx information Is the individual followed by a psychiatrist What medication is the individual prescribed What recent medication changes occurred over the past six months

45. Functional Behavior Assessment Questionaire 6. Describe the individual’s sleep patterns 7. Describe the individual’s eating habits 8. In the past two years, what changes occurred in the individual’s environment 9. Any history of trauma* *if so would he benefit from Trauma informed Treatment?

46. Functional Behavior Assessment Questionaire 10. Identify the most pressing maladaptive behavior 11. What does it look like 12. Frequency13. Duration14. Typical consequences

47. FBA EXERCISE

48. Functional Behavior Assessment Questionaire Time/people/activities associated with maladaptive behavior 17. Time/people/activities not associated with maladaptive behavior 18. Possible changes to the environment 19. What occurs before maladaptive behavior

49. Functional Behavior Assessment Questionaire Question 1-19 can be use as an orientation to the presenting issue and an avenue for additional investigation Question 20-24 is usually answered during a future meeting

50. Functional Behavior Assessment Questionaire 20. Precursor behaviors 21. Replacement behavior 22. Teaching replacement behavior 23. Reinforcing replacement behavior 24. Making maladaptive behavior less reinforcing