Social Welfare Department Clinical Psychological Service Branch Central Psychological Support Service Staff Training for

1. Social Welfare Department Clinical Psychological Service Branch Central Psychological Support Service Staff Training for ICCC Topic: Managing Challenging Behavior in Young CSN: Positive Approach(Positive Behavior Support, PBS)正面行為支援

2. Presentation Outline • Introduction • Functional Assessment (功能評估) • Interventions: Environmental Arrangement • Interventions that Honor the Function of the Behavior • Interventions that Do Not Honor the Function of the Behavior

3. Challenging Behavior “Behavior emitted by a learner that results in self-injury or injury to others, causes damage to the physical environment, interferes with the acquisition of a new skill, and/ or socially isolates the learner” Doss & Reichle (1991)

4. Forms of Challenging Behavior

5. REACTIVE Intervention consequences implemented after behavior has been produced ANTECEDENT Intervention implemented prior to emission of challenging behavior in situations associated with challenging behavior Intervention Strategies

6. Traditional Reactive Strategies • Reinforcing Alternative Behaviors • Differential Reinforcement of Low Rate • Extinction • Timeout • Response Cost • Over-correction • Satiation • Punishment

7. Antecedent StrategiesWhy Are They Advantageous? • More effective than strategies that simply serve to control or suppress behavior • Opportunities can be generated • Less disruptive to the environment than reactive procedures • Educative: new skills may be acquired in the absence of frazzle(tedious and tiresome effort) • Opportunities to interrupt chain of stimuli associated with challenging behavior • Do not have to deal with the behavior

8. Functional Assessment

9. Functional Assessment • a process of determining the relationship between events in a person's environment and the occurrence of challenging behaviors. • assumes that individuals with disabilities behave in adaptive ways to ongoing changes in their environment (except those habitual behaviors that do not have obvious functions or symptoms of particular disorder)

10. A description of the challenging behavior An identified social function or purpose of the behavior Main Outcome of a Functional Assessment Identified setting event(s) associated with the behavior

11. Case 1 Behavior • Mary hits other children during gross motor time when she does not get her way Functional Analysis • Get tangibles Setting Event • Inadequate sleep, sickness Other factors • Limited verbal expression skills • Lack of structure and rules in the gross motor area • Overcrowding in the gross motor area

12. Case 1 Behavior Intervention Plan • Teaching appropriate behavior to get what she wants • Provide support and cues to use appropriate behavior • Praising appropriate behavior • Structure the GM area to eliminate the possibility of engaging in the challenging behavior • Involved speech therapist to teach him specific phrase and sentence to express herself in the setting • Discuss with parents about sleeping pattern to ensure adequate sleep and develop good habit • Pay more attention to child when she is sick

13. Case 2 Behavior • Tom makes irrelevant and inappropriate comments during story time Functional Analysis • Get attention Setting Event • Usually on Monday • Sit at the back Other factors • Child has told teacher that his mother has favoritism towards his younger brother • The format of the story time allow limited student participation

14. Case 2 Behavior Intervention Plan • Increase student participation in story time and require student to raise up hand before speaking • Give him chance to do classroom duty and praise pro-social behavior • Discuss with parents about sibling rivalry issue • Expand interest that he can engage himself • Teach him techniques to control himself and provide reinforcement • Seating arrangement to minimize opportunity to talk at the back

15. Case 3 Behavior • David throws temper tantrum when he is doing his class-work in writing Functional Analysis • Avoid task Setting Event • Reprimand by parents the day before on homework in writing • Teasing by peer about his poor writing Other factors • Child has fine motor skills problem • Parents are strict in demand of his writing skills • Child easily felt anxious and is sensitive to comment

16. Case 3 Behavior Intervention Plan • Recognize the physical signs that he is becoming anger. Arrange quiet corner when he is distressed • Teach him relaxation skills • Practice communication skills of requesting for a break and assistance • Discuss with parents about parenting issues • Peer mediating strategies – buddy program • Seeking support from professional • Curricular and environmental modification to facilitate him learning in proper pace

17. Functional Assessment Methods • Indirect Assessments • Direct Observation Strategies • Environmental Manipulation Assessments

18. Indirect Assessment (Appendix C,D & E)

19. Indirect Assessment • What exactly does the behavior look like? • What do you think is the possible motivation/ function for behavior? • What events/ situations predict the behavior? • What does the child like and not like? • How does the child communicate wants and refusal? • What are some other factors (medical, outside school schedule) that may affect behavior?

20. Indirect Assessment Setting Events • Conditions that occur concurrent with problem behaviors or are more distant in time and increase the probability that challenging behavior will occur.

21. Indirect Assessment Setting Events • Staff changes • Medications were changed • Slept fewer/ more hours than usual • Show signs of illness • Chaotic/ Demand situations • Surprise visits from people • Unexpected things occur • Experienced a long waiting time • Temperature of environment was too hot/cold • Unpleasant environment (physical/ social) • Reprimand by caregiver • Was aggressed upon by another peer

24. Direct Observation Strategies (Appendix A & B)

25. Direct Observation Strategies – ABC Charts

27. Functional Analysis (Appendix F & G)

28. Function of Challenging Behavior Obtain Desirable Events Avoid/ Escape Undesirable Events Tangible/ Sensory Tasks/ Change/ Sensory Attention Attention

33. Environmental Manipulation Assessments What are they? • Controlled comparisons of at least two different antecedents or two different consequences that are hypothesized to influence the emission of challenging behavior Why should they be implemented? • To clearly identify specific antecedents and/or consequences influencing challenging behavior that could not be isolated during direct observation

34. Behavior Intervention Plan (Appendix H & I)

37. Interventions: Environmental Arrangement

38. Environment Arrangement • Goal: safe, easy-to-use, promoting desired behavior and preventing problems

39. Key Ingredients for Structuring Your Program for Positive Behavior • Create a physical arrangement that eases management, promotes interaction, and prevents problems. • Establish program rules that help guide behavior of children and adults. • Utilize staff in an efficient and effective manner. • Provide materials that promote attention and persistence. • Develop a daily schedule that establishes transitions and routines.

40. Tips for Arranging Activity Areas • Activity areas - distinct areas, separated by low dividers that the teacher can easily see over • Separate areas by using low barriers, tape on floor, carpet, tables, shelving, room dividers. • Label activity areas (e.g., a picture of children playing with blocks with the word BLOCKS). • Activity areas should be arranged so that quiet activities are together (e.g., art, reading, and listening to tapes).

41. Tips for Arranging Activity Areas • Louder activity areas should be together (e.g., blocks, dramatic play) • Separate quiet & active areas (e.g., cars & reading) • Check traffic patterns between activity areas, bathrooms, etc. • Are they planned so that children can easily move from one area to another? • Activity areas need to be accessible to all children in the room • Limit the number of children in an activity area • Quiet area should be provided for relaxation or quiet time.

42. Sample Classroom Rules • Share materials. • Talk in a GENTLE voice. • Listen to the teacher. • Touch gently. • Walk (not run) in the classroom. General Rules for Materials • Have a plan in place for those items which cannot be shared (e.g., timer, list, necessary social skill “May I play with the phone next?”). • Adaptive equipment may be needed to help children participate in all activities (e.g., clamps to hold paper, page turner)

43. Utilizing Staff Arrangement • Zone vs. Child directed monitoring. Responsibilities • Each member of the staff should know what he or she should be doing at any given time. • All responsibilities related to paperwork, teaching assignments, data collection, materials preparation, etc., should be clearly delineated. • These responsibilities should be translated to the daily schedule.

44. Staff Planning Allocate sufficient time for: • planning individual or group activities. • preparing classroom materials. sharing observations,  information, and strategies with  each other, evaluating the effectiveness of  the activities and strategies. • Communication

45. Staff Communication • Daily meetings (15 - 20 minutes) attended by teaching staff provides an opportunity to discuss: • events of the day • progress of individual children • strategies to make instruction more effective plans for the future

46. Staff Communication • Weekly meetings attended by teaching staff and consultant-specialists provides an opportunity: • for specialists to present assessment data for specialists to teach teaching staff therapeutic or instructional techniques for individual students • for the team to develop instructional plans that target IEP goals in the context of functional skills.

47. Scheduling Activities • Schedule all activities including transitions, snack, and play. • Alternate “work” and “play” to build natural rewards into your schedule. • Order activities to reflect when they would occur in the natural environment. • Provide a variety of interesting activities. Interspersing active and quiet activities and utilizing changes in settings. • Follow your schedule but be flexible. • If you find yourself falling behind, change your plans.

48. Scheduling Activities Indicators of Disorganized Environment • Noise level • Staff placement • Schedule not followed • Poor organization of space • Transitions not planned • Children waiting

49. Peer-Mediated/Consequence Strategies Peer-Mediated Strategies • Buddies or role models Consequence Strategies • Have the child ring a bell when they get to the transitioning activity • Have the child beat the buzzer when they transition to another activity • Have the child receive directions for the new task by a novel method (e.g., off a tape recorder, turning a picture over).

50. Rearranging the Environment Physical Arrangement • Low Barriers • Space and density • Similar activities • Clearly defined areas Staffing Patterns • Zone vs. child directed • Rotate children between activities Materials • Interesting & accessible • Rotate Work &have extra batteries