Positive Behavior Support Workshop - Oregon Intervention System 2014

1. OIS-P“P” is for “Parent!” Oregon Intervention System 2014

2. What is OIS? OIS is a process for quickly assessing challenging behavior, implementing Positive Behavior Supports (PBS) and, if necessary, safe interventions in community programs.

3. Learning ObjectivesYou will receive basic information on the following topics: • Positive Behavior Supports (PBS) • Understanding behavior • Stress and stress management • Strategies for preventing and responding to challenging behaviors • Techniques for keeping people safe in a crisis

4. Expectations • Respect each other • Participate • Keep confidentiality • Follow through with expectations after this class

5. Disclaimer The processes outlined in this workshop have been proven safe and effective when applied correctly. • However, proper implementation is the responsibility of the persons involved. *OIS techniques must be trained by a certified OIS instructor.

6. Positive Behavior Support • Understand the person • Understand the behavior • Support dignity and give respect • Set people up for success • Increase quality of life We are more alike than different

7. A different way of thinking We used to say “How do we stop this behavior?”

8. Positive Behavior Support skills barriers

9. Positive Behavior Support • Examine environments • Design supports • Increase structure and predictability • Make challenging behavior lessnecessary or less efficient • Balance what is important to and for the person

10. What is a behavior? An action performed by an individual to meet a need or want under particular circumstances In simpler terms, it’s what people do.

11. Behavior 101 Behavior… • Is meaningful and occurs for a reason • May change as our environments change • Can be observed and measured • Is often communication • May be internally driven

12. The Behavioral Assessment Experience The “Functional Assessment process” includes: • Observation • Interviews • Documentation/file review

13. Purpose of Behavioral Assessment • To identify frequency, duration, intensity, and severity of a challenging behavior • To identify the factors that contribute to a hypothesis about the reason for the challenging behavior What & why

14. Behavior Pathway Pre-sets Setting Events Triggers Or Cues Behavior Consequence

15. Who is your child? • Strengths, skills, & interests • Preferences (likes & dislikes) • Personality • Age • Family values • Culture • Personal space needs • History/experiences Pre-sets

16. Pre-sets: What your child brings • Past experiences that have helped shape the person’s perspective and personality • Medical and mental health • Cognitive abilities • Communication skills Pre-sets

17. Setting Events: The Adjustable What “sets up” the behavior • People • Times of day • Locations/environments • Activities/transitions • Internal factors They stack up!

18. Environmental factors Are there any recent changes to the home? What does the environment look like? What is your child’s preferred environment? How is your child affected by temperature, smells, noise levels, changes in environment?

19. Elements of Verbal Communication

20. Elements of Unspoken Communication

21. Power struggles Two people imposing their will upon each other

22. What “sets off” the behavior Trigger

23. Common triggers • “No” • “Not now,” “Later,” “Soon,” “Wait” • Unexpected changes in environment or plans • Personal space or property “invasion” • Change in internal state The straw that broke the camel’s back

24. Consequence What happens immediately after the behavior occurs; what the person gets or avoids as a result of the behavior What is added to or removed from the person’s environment that is acting as a reinforcer for the behavior?

25. Common reinforcing consequences The child avoids – Information Affection and interaction Basic need met Sensory stimulation Activity Unclear transitions/activities Unpleasant sensory stimulation/activities Demands The child gets –

26. A challenging behavior • Is currently the best tool the person has to get a need met Pre-sets Setting Events Triggers Or Cues Behavior Consequences They work!

27. Stress Our response to stimuli

28. Unspoken Stress Key Stress Cycle Parent emotions Parent actions Beyond De-escalation 10% Crisis 50% ↓ De-Escalation Escalation 75% Stabilization Trigger Baseline 80%↑ Post-Crisis Drain

29. Alarm Reaction Process Everyone freezes at the first sight of danger. Most of us progress to flight or fight. Some people get stuck in freeze or progress to freeze when hope of survival is diminished. All of these responses shut down the thinking brain.

30. Physiology of Alarm ReactionHow we know its happening

31. Biologically-driven stress responses

32. Ongoing stress creates issues • Weight gain or loss • Depression • Insomnia • Shortness of breath • Upset stomach • Ulcers • Anxiety • Constipation • Fatigue • Headaches • High blood pressure • Neck or back pain

33. Writing your stress management plan

35. Strategies Why you’re here, right?

36. General strategies for supporting a personduring each phase

37. Baseline Supports Proactive & preventative strategies

38. Support relationships “Loneliness may be the number one cause of challenging behavior.” -David Pitonyak

39. Prevent power struggles • Offer choices • Avoid using the word(s) “no,” “later,” “in a minute” • Build trust by following through with agreements and promises • Be confident that there are solutions • Avoid being reactive

40. Support communication • What skills does your child have to express his or her needs? • Does your child have an effective communication system in place, or does one need to be developed?

41. Support understanding • Consider the following • Are requests presented as a question? • Am I conveying confidence in the person and myself? • Am I making a request in a way that the person can understand? • Is the message I am attempting to convey appropriate to the person’s level of escalation?

42. Offer structure & predictability Does your child have these answers: Where am I going? What am I doing? How much am I doing? How do I know the activity is over? What’s next?

43. What does structure look like? Routines Visual cues (objects, pictures) Schedules (calendars, checklists) Social Stories™ Verbal cues (first/then or “__ more minutes”)

44. Sometimes routines need to be conveyed in an alternate manner

45. Teach a new way to get a need met Pre-sets Setting Events Triggers Or Cues Challenging Behavior Maintaining Consequence Alternative Behavior

46. Escalation Supports Responding to signs of escalation

47. Behavior Management 101 • Use of punishment is the least effective way to alter challenging behavior. PUNISHMENT

48. What’s true about punishment • Effective in the presence of the punisher: Increases covertness. • Requires greater resources to be effective: Increases severity, constant vigilance. • Produces unintended consequences: Damages relationships, increases anger & aggression, changes worldview. • Focuses attention on negative behavior: You get more of what you pay attention to!

49. Facing the facts • If the behavior continues to occur, then it is not working to decrease the behavior. • Often we think punishment is the only way to reduce problem behavior but upon studying the result we notice it may reinforce the behavior.

50. Time out vs. break Time out: Parent is in charge Tells child where to go and when time out is over Break: Child is in charge Decides where to go and how long they need to be there