Presentation Transcript

1. Advanced BehaviorInterventions

   Rose Iovannone, Ph.D., BCBA-D iovannone@usf.edu 813-974-1696
2. Agenda Technically Adequate FBAs/BIPs Refresher of PTR Linking hypotheses with behavior interventions Behavior interventions
3. Objectives Participants will: Develop a task analyzed behavior intervention plan that is linked to a FBA hypothesis that includes: A prevention intervention A replacement skill A functional equivalent reinforcer Complete a coaching checklist for training others to implement the plan Complete a fidelity measure Identify key coaching/consultation skills
4. ESSENTIAL COMPONENTS Technically adequate fba/bipS
5. Core Components of Technically Adequate FBAs/BIPs FBA Input sought from multiple sources Problem behavior that is focus of FBA identified and clearly defined Baseline data indicate target behavior is a problem Antecedents that predict problem behavior clearly identified/described Setting events considered and (if applicable) clearly identified/described Antecedents that predict absence of problem behavior clearly identified/describes Consequences (responses of others) immediately after problem behavior identified and described Hypothesis developed from FBA data and includes antecedents, setting events (if applicable), behavior, and function Function is one recognized and identified by “leaders” in the field Social reinforcement—e.g., obtain/get attention, tangibles, activities, sensory Negative reinforcement—e.g., escape/avoid/delay/terminate attention, tangibles, activities, sensory
6. Core Components of Technically Adequate FBAs/BIPs BIP Developed relatively soon after FBA (e.g. within 30 days) FBA hypothesis is included or referenced on BIP Minimum of one antecedent strategy: Included Linked to FBA hypothesis (when) Described in enough detail to pass “stranger test” Minimum of one teach strategy: Included Linked to FBA hypothesis (functional equivalence or incompatible behavior) Described in enough detail to pass “stranger test” Minimum of one reinforce strategy: Included Linked to FBA hypothesis (functional equivalence provided) Described in enough detail to pass “stranger test” Strategy included to no longer reinforce problem behavior (change maintaining responses) Need for crisis plan considered and described in detail (if applicable) and linked to hypothesis Evaluation plan described in detail Fidelity plan described in detail
7. PTR—Refresher
8. What is Prevent-Teach-Reinforce (PTR)? Research project funded by U.S. Department of Education, Institute of Education Sciences University of South Florida Three central Florida school districts University of Colorado, Denver Two Colorado school districts Purposes: Answer the call for rigorous research Evaluate effectiveness of PTR vs. “services as usual” using randomized controlled trial Evaluate effectiveness of “standardized “ approach
9. Prevent-Teach-Reinforce: PTR Intervention teams given manual and assigned PTR consultant Five step process (aligned with problem solving process): Teaming Goal Setting (Identification of Problem) Functional Assessment (Problem Analysis) Intervention (Intervention Implementation) Coaching and fidelity Evaluation (Monitoring and Evaluation of RtI)
10. Step 1: Teaming Teaming: A collaborative process Members Person with knowledge of student (e.g., Classroom teacher, instructional assistant, parent) Someone with expertise in functional assessment, behavioral principles (PTR consultant, school-based consultant) Someone with knowledge of context (e.g., administrator or designee Purpose: Evaluate strengths and weaknesses of team functioning Outline roles and responsibilities Determine a consensus-making process

11. Step 2-Goal Setting

    Identify the problem
12. What Determines Success? Analysis of outcomes of 800+ consultation cases involving elementary students Problem identification = 43% Problem analysis & plan development = 31% Goal attainment occurred in 97% of cases in which a plan was implemented “consultants successful in identifying problems were almost invariably able to solve those problems” Bergan & Tombari, 1976
13. Step 2: Goal Setting Purpose: Identify behaviors of greatest concern to the team and possible replacement behaviors (teach) Prioritize and operationalize behaviors targeted for intervention Develop teacher friendly baseline data collection system Targeted Areas: Problem behaviors Social skills Academic behaviors
14. Step 2: Data Collection System Behavior Rating Scale – BRS (cf., Kohler & Strain, 1992) Direct Behavior Rating (DBR)—Hybrid assessment combining features of systematic direct observations and rating scales Efficient and feasible for teacher use Provides data for decisions Prioritized and defined behaviors measured Requires minimum of 1 appropriate and 1 inappropriate behavior
15. Case Study- Mike: Behavior Rating Scale 01/15
16. Analyze the Problem Step 3: Functional behavior assessment
17. Step 3: PTR Functional Assessment PTR Assessment (FBA) Checklist format Prevent = antecedents Teach = function, possible replacements Reinforce = consequences, possible reinforcers One form completed for each problem behavior by each team member Information leads to hypothesis
18. Learned Functions of Behaviors GET (Positive Reinforcement) Obtain Activities, people, tasks, tangibles, sensory, pain attenuation GET OUT OF (Negative R) Escape/Avoid/Delay Activities, people, tasks, tangibles, sensory, pain
19. Step 3: Case Study – Mike Hypotheses Inappropriate Appropriate
20. Step 4 Behavior Interventions
21. Behavior Intervention Plan Development: Essential Features Behavior interventions selected Team/teacher provides description on how interventions will look in classroom setting Facilitator guides the team/teacher by using ABA principles to develop most effective intervention that matches the team/teacher context Each intervention selected is described in detail by task-analyzing steps, providing scripts, describing adult behaviors, NOT student behaviors After plan developed, time is scheduled to train the team/teacher the strategies prior to implementation Plans for training students and other relevant individuals Support provided once plan is implemented
22. How to Link Hypothesis Statements to Behavior Interventions The hypothesis statements link to behavior interventions by: Modifying the antecedent(s) identified, Teaching alternative appropriate behaviors to get the same payoff, Providing alternative ways of responding to the appropriate and problem behavior (including crisis management)
23. Hypothesis Link When Jeff is presented with demands to start non-preferred academic tasks, specifically independent writing, he will become disengaged and walk around the room, talk to and touch peers, put his head down without initiating writing. As a result, he gets to avoid/delay the non-preferred task. . Behavior Disengaged-walk around room, bother peers, Reinforce Avoid/delay non-preferred task Prevent Teacher request to start the non-preferred task Setting Event None identified
24. Rule #1 You should not develop a plan to decrease the problem behavior without first identifying the alternative, desired behaviors the person should perform instead of the problem behavior (O’Neill)
25. Rule #2 Use the functional equivalence reinforcement (i.e., escape and/or obtain) identified in the hypothesis in your behavior support plan. Only use artificial reinforcement (e.g., tangibles) if the functional equivalence is not enough.
26. Rule #3 Develop an intervention to modify the trigger (prevention information) so that the problem behavior is no longer necessary.
27. The Three I’s Function-Based Support Plans will be effective when IRRELEVANT A prevention intervention that modifies the context so that the problem behavior is no longer necessary to perform is included. INEFFECTIVE The replacement behavior serves the same function (obtains the same outcome) as the problem behavior - if it doesn’t work, the student won’t do it. INEFFICIENT The replacement behavior works at least as quickly and easily as the problem behavior - if it works but is harder to perform, the student won’t do it.
28. Jeff-matching hypothesis to interventions Problem Behavior Disengaged Maintaining Consequences Reinforce ESCAPE!!! Setting Events NONE Prevention Triggering Antecedents Request to do a non-preferred task = writing Replacement Behavior )equivalent or incompatible) Engage in Task Modify trigger Choices Environmental support
29. Step 4: Writing the Intervention Plan Task analyze each step of the plan NOT— “give student choices” YES— Prior to the start of independent reading, tell the student “we have 2 worksheets today” (show worksheets). “Which worksheet would you like to do first?” If teachers do not know how to do it, they will not implement the strategy.
30. Prevention Interventions
31. PTR Prevention Strategies Providing Choices Transition Supports Environmental Supports Curricular Modification Adult-Verbal Behavior Classroom Management Increase Noncontingent Reinforcement Setting Event Modification Opportunity for Prosocial Behavior Peer Modeling or Peer Reinforcement
32. Prevention Intervention:Choice-Making
33. Choices Individual selects preference from among 2 or more valid options Reduces likelihood of exhibition of escape and avoidance behaviors associated with demands Choice strategies: (adapted from Fredda Brown) Between tasks Within tasks Where When Person(s) Rejection Termination
34. Choice Making Steps to Build Intervention Step 1: Determine the context (antecedent) identified in the hypothesis Step 2: Determine choice options (from 7 categories) that can be presented during specified context Step 3: Select the choice options that will be offered Step 4: Decide how the choice options will be presented to the student (when, who, how) Step 5: Decide response to student after making choice Step 6: Decide how to release to choice
35. Environmental SupportsUsed when hypothesis (when part)suggests that visual cues/organizational tools or external reminders may make context/antecedent less aversive Examples of environmental supports for anyone Traffic signs Microsoft Outlook, tools, reminders Restaurant menus To do lists Every app you can think of Examples of environmental supports for students Visual checklists Reminders of reinforcement Visual cues Timers Visual mnemonics Communication tools Schedules
36. Environmental Support Steps Step 1: Determine nature of antecedent and type of environmental support that may work best Step 2: Develop the environmental support Step 3: Determine how to use environmental support (when, who, how to present) Step 4: Teach student use of environmental support
37. Jeff: PTR Intervention Plan Prevent
38. Jeff—Intervention Plan Prevent
39. Activity In your group/team, develop a prevention intervention for the following hypothesis. When requested to transition from a preferred to a non-preferred activity, Joe will start calling the adults and peers names and use cuss words. As a result, he (a) avoids/delays the transition and (b) gets responses/attention from both adults and peers. Steps Identify the antecedent/prevention information Review the prevention interventions Decide upon one intervention Develop a step-by-step plan for implementation Be prepared to share
40. Sharing Time
41. Teach Interventions
42. Replacement Behaviors Replacement behaviors are what we want the student to do instead of the problem Effective replacement behavior must: 1. Be incompatible with the problem. 2. Serve the same function as the problem. PROBLEM FUNCTION REPLACEMENT
43. Replacement Behavior Teaches more appropriate, but equally effective, means of getting reinforcer (escape/obtain) Must be: Socially valid Simple Efficient Likely to be reinforced by others in student’s life
44. Considerations When Teaching Replacement Behaviors Identify alternative behavior as easy for student to do as challenging behavior (efficiency) Consider the replacement behavior is a skill or performance deficit Directly teach student new behavior including how and when to use Make sure all other’s in student’s environment are consistent in teaching the replacement behavior.
45. Replacement Behaviors Communicative replacement Reject offer of undesired item or event Request alternative activity Request assistance Request break Request work check Incompatible replacement (sample) Engagement Independent task completion Raise hand Appropriate social interactions Appropriate commenting
46. Teaching “Request a Break” First, determine the point in which the problem behavior occurs after presentation of the antecedent Deliver the prompt for using the replacement behavior (e.g., “I need a break”) just prior to above point of time. Release student to break immediately after correct response exhibited and provide verbal reinforcement for using replacement behavior
47. Request a Break, continued Provide inducement to get back to task Fade prompt gradually Evaluate need for tolerance for delaycue (time delay for escape)
48. Teach Incompatible Behavior Raise hand Step 1: Determine if skills is a performance or skill deficit If skill deficit, break down behavior into discrete steps and determine steps student needs to acquire If performance deficit, reinforcement part of intervention will be extremely important Step 2: Teach student when to use new behavior and what will happen when they use new behavior Examples and nonexamples Opportunity to practice with feedback Determine prompting required until skill is acquired Step 3: Determine how skill will be generalized/maintained
49. Jeff— Teach Intervention Plan
50. Activity In your group/team, develop a teach intervention for the following hypothesis. When requested to transition from a preferred to a non-preferred activity, Joe will start calling the adults and peers names and use cuss words. As a result, he (a) avoids/delays the transition and (b) gets responses/attention from both adults and peers. Steps Identify the problem behavior Identify the function Agree upon a replacement behavior (functional equivalent or incompatible) Review the teach interventions Decide upon one intervention Develop a step-by-step plan for implementation Be prepared to share
51. Sharing Time
52. Reinforce Interventions
53. Reinforcement Four rules (Terry Scott) Use the least amount that is necessary to get the replacement behavior Use the natural reinforcement (i.e., function) Be consistent and immediate in delivering the reinforcer-establish a routine Teach the student how he/she will get the reinforcement
54. Jeff—Reinforce Intervention Plan
55. Jeff—Reinforce Intervention Plan
56. Activity In your group/team, develop a reinforce intervention for the following hypothesis. When requested to transition from a preferred to a non-preferred activity, Joe will start calling the adults and peers names and use cuss words. As a result, he (a) avoids/delays the transition and (b) gets responses/attention from both adults and peers. Steps Identify the function. Determine how the function (outcome) can be delivered as an intervention Review the reinforce interventions Decide upon one intervention Develop a step-by-step plan for implementation Be prepared to share
57. Sharing Time
58. Coaching Steps Core components of each behavior intervention strategy listed on coaching/fidelity form. Primary adult behaviors (physical or verbal actions) & materials If applicable, student behaviors included. During coaching session, facilitator gives teacher behavior intervention plan and coaching form. Facilitator introduces coaching form, e.g., “We’re going to go over the steps of the behavior plan strategies to make sure they are still making sense to you and are things that can be done by you in your classroom. If there is anything that you feel isn’t going to work, we can make changes today.”
59. Coaching Steps Several methods for coaching the teacher. Can choose one method, combination of two, or all three Discussion—facilitator asks teacher to verbally describe (in his or her own words) each of the interventions. Ensures teacher describes each step of the intervention Teacher can refer to coaching form to cue core steps Q & A—facilitator asks teacher questions about strategies. For example, choice-making“When are you going to offer the choices to X?”; “What kind of choices will you offer X?”; etc. Role Play (preferred method)-facilitator plays role of student and asks teacher to perform plan steps as they would with student.
60. Coaching Steps Check ‘Y’ or ‘N’ whether teacher demonstrated competence with plan steps Remediation: For any step teacher did not demonstrate correctly or skipped, Review step with teacher Provide another opportunity for teacher to demonstrate competence If successful, coaching session finished If unsuccessful, choose from the following: Provide more opportunities to review and practice step Ask teacher what features make step difficult and adapt to make feasible Select different intervention checked on PTR intervention Checklist that matches hypothesis. Schedule another meeting to develop new intervention Schedule another coaching session
61. Coaching Steps Successful training: Decide who else needs to be trained(e.g., student, other school staff, parent) Try to be there when teacher trains student or offer to train student Determine start date of intervention plan Can choose to implement the intervention in phases. Prevent first, then teach/reinforce Teach/reinforce first, the prevent Training checklist can be used as fidelity measure rather than developing separate checklist

62. Jeff Example

63. Jeff Coaching Plan (Sample)
64. Activity Develop a coaching/fidelity plan for your behavior intervention Be prepared to share Discuss how you would collect data on response to intervention (Behavior Rating Scale, other)
65. Questions?
66. PTR Publications PTR Manual Dunlap, G., Iovannone, R.,Kincaid, D., Wilson, K., Christiansen, K., Strain, P., & English, C., 2010. Prevent-Teach-Reinforce: The School-Based Model of Individualized Positive Behavior Support. Baltimore: Paul H. Brookes. Journal Articles Iovannone, R., Greenbaum, P., Wei, W., Kincaid, D., Dunlap, G., & Strain, P. (2009). Randomized controlled trial of a tertiary behavior intervention for students with problem behaviors: Preliminary outcomes. Journal of Emotional and Behavioral Disorders, 17, 213-225. Dunlap, G., Iovannone, R., Wilson, K., Strain, P., & Kincaid, D. (2010). Prevent-Teach-Reinforce: A standardized model of school-based behavioral intervention. Journal of Positive Behavior Interventions, 12, 9-22 Strain, P. S., Wilson, K., & Dunlap, G. (2011). Prevent-Teach-Reinforce: Addressing problem behaviors of students with autism in general education classroom. Behavior Disorders, 36, 160-171. Iovannone, R., Greenbaum, P., Wei, W., Kincaid, D., & Dunlap, G. (in revision). Reliability of the Individualized Behavior Rating Scale-Strategy for Teachers (IBRS-ST): A Progress Monitoring Tool.  Manuscript submitted for publication. Sears, K. M., Blair, K. S. C., Crosland, K., & Iovannone, R. (in press). Using the Prevent-Teach-Reinforce model with families of young children with ASD.Journal of Autism and Developmental Disabilities.