Introduction to Positive Behavior Support

1. Introduction to Positive Behavior Support Geunyeong Pyo, Ph.D.Clinical Coordinator for Psychological ServicesIL Dept of Human ServicesDivision of Developmental Disabilities

2. Purpose of the Course • To provide an introduction to Positive Behavior Support (PBS) • To review some basic concepts of behavior analysis • To introduce the basics of a functional assessment • To introduce basic concepts of designing a PBS plan

3. Positive Behavior Support • Based on applied behavior analysis • Response to the 1997 amendments to the Individuals with Disabilities Education Act • Evolved to improve and extend comprehensive interventions for individuals with severe problem behaviors • Systemic and individualized strategies for achieving outcomes and preventing problem behaviors

4. Positive Behavior Support • Respect for all citizens’ rights • Treating all people with respect and dignity • Person-centered supports and services • Prevent abuse and neglect

5. ABC Model of PBS Antecedent Behavior Consequence

6. ABC Model • Antecedent: You see a coworker when you arrive at work • Behavior: You say “hello” • Consequence: Coworker says “hello” back to you

7. Behavior • Behavior is everything a person does. • “Behavior” refers to all behaviors, not just problem behaviors. • Behaviors that can be observed • Behaviors that can be heard/seen • People can agree something happened • Behaviors that can be measured

8. Behavior • Kate is angry vs. Kate hit Mark • Mary is depressed vs. Mary is crying • Ryan is anxious vs. Ryan is pacing • Sue is listening vs. Sue is looking at • the speaker

9. Behavior “Jack has a personality issue. He can tell you what to do when somebody annoys him (such as take a deep breath, count 1-2-3), however, he chooses to be aggressive instead of using the knowledge.”

10. Behavior Group Activity 1. Describe the most recent behavior of an individual you are supervising. 2. Discuss with your partner whether your description was about a behavior.

11. Behavior Take-home-message: Rely on your Eyes and Ears. Do not rely on what you are thinking!!!

12. ABC Model of PBS Antecedent Behavior Consequence

13. Why Do We Engage in Behaviors? • People are likely to engage in behaviors that work. • You see a coworker when you arrive at work • You say “hello” • Coworker says “hello” back to you • People are less likelyto engage in behaviors that do not work. • You see a coworker when you arrive at work • You say “hello” • Coworker did not say “hello” to you.

14. Principles of Behaviors • Almost all human behavior is learned • All behaviors occur for a reason. • No behaviors occur “out of blue.” • Behaviors continue to occur because they are effective. • Behaviors stop occurring because they are ineffective.

15. Consequences • Events occurring after the behavior • Consequences can be good or bad • Get what you want • Get away from you don’t like • People leave you alone • Get a scolding from others • lose something valuable

16. Consequences • Reinforcement Consequences increase the probability of the behavior. • Punishment Consequences decrease the probability of the behavior.

17. Reinforcement • Positive Reinforcement increases behavior by the addition of a desirable event when the behavior occurs. • Praise • Edibles • Money • Negative Reinforcement increases behavior by the removalof an aversive event when the behavior occurs. • Excuse from chores • Escape from a crowd • Stops pain

18. Punishment • Positive Punishment decreases behavior by the addition of an aversive event when the behavior occurs. • Verbal reprimand • Increased work • Negative Punishment decreases behavior by removing a desirable event. • Time out • Removing Privileges, fines

19. Negative Reinforcement vs. Punishment • Negative reinforcement increases behavior by the removal of a negative experience • Punishment always decreases behavior

20. Summary Table

21. Misuse of Reinforcement • Laura lives in a group home with three other people. At supper time, all four persons go to the table. When a staff member begins giving one of Laura’s peers a serving of food before serving Laura, Laura begins to scream and pull her own hair. The staff member then quickly gives Laura a food serving, and Laura calms down. • Jefferson has a supported job in a printing company, in which he does several job tasks. When he is given the task of folding mailing fliers, which he knows how to do, he always tears the flies. When he begins the tear the fliers, that task is removed from him.

22. Misuse of Reinforcement Former president Nixon and Henry Kissinger were sitting in the Oval Office discussing policy matters. King Timahoe, Nixon’s Irish setter, came in and began chewing on the rug. The president commanded him to stop. King Timahoe kept right on chewing. The president commanded again. More chewing. Finally, Nixon opened his desk drawer, took out a dog biscuit and gave it to King Timahoe. “Mr. President,” said Kissinger, “you have taught that dog to chew the rug.” (Based on Roberts & Santogrossi, 1976)

23. Misuse of Reinforcement “Our young daughter had adopted a stray cat. To my distress, he began to use the back of our new sofa as a scratching post. ‘Don’t worry,’ my husband reassured me. ‘I’ll have him trained in no time.’ I watched for several days as my husband patiently ‘trained’ our new pet. Whenever the cat scratched, my husband deposited him outdoors to teach him a lesson. The cat learned quickly. For the next 16 years, whenever he wanted to go outside, he scratched the back of the sofa.” (Reported in Behavior Analysis Digest, March, 1990).

24. Reinforcers • Tangibles: food, drink • Favorite activities: visiting family, watching TV, dancing, listening to music, singing • Attention: positive/negative verbals, physical contact • Social reinforcers: praise, positive feedback

25. Types of Reinforcers • A Primary Reinforcer has an intrinsic reinforcing value; only temporarily lose ots effectiveness through satiation; e.g. food, drink • A conditioned reinforcer originally has no reinforcing value, but became a reinforcer after being paired with a primary reinforcer; e.g., money, token, sticker • A back up reinforcer is paired with a conditioned reinforcer to make it effective.

26. Reinforcers • No single item or event is reinforcing to everyone • A reinforcer for an individual can be a punisher for another individual. • The strength of an item or event to serve as reinforcer can vary with time, circumstances, satiation level, and deprivation level. The only way we can tell is by its effect on behavior !!

27. Misuse of Reinforcement “Our young daughter had adopted a stray cat. To my distress, he began to use the back of our new sofa as a scratching post. ‘Don’t worry,’ my husband reassured me. ‘I’ll have him trained in no time.’ I watched for several days as my husband patiently ‘trained’ our new pet. Whenever the cat scratched, my husband deposited him outdoors to teach him a lesson (Your intention). The cat learned quickly. For the next 16 years, whenever he wanted to go outside, he scratched the back of the sofa (Actual result).” Lesson: You have to think like the cat !!!

28. Identifying Possible Reinforcers • Ask him/her • Observe what s/he chooses when free to do so • Check records to see what’s worked in the past • Try different things • Measure the effects on the behavior

29. Punishers • Verbal reprimand • Planned ignoring • Extinction • Response interruption • Time out • Removing a privilege • Suspension from work

30. Punishment • To stop a problem behavior immediately to prevent harm • To teach alternative positive behavior • Immediate effect • The effect does not last. • should be used when the side effects of punishment are clearly outweighed by the potential benefits.

31. Side Effects of Punishment • Reactive aggression • Adaptation • Avoidance of the person/setting delivering punishment • Suppression of behaviors similar to the target behavior but appropriate • Teaches the person to use punishment to others

32. Punishment • An informed consentis required from the guardian and/or the individual. • A detailed behavior program is required to specify how to use punishment (to avoid an abuse). • Punishment should be combined with replacement procedures and preventative procedures—it should be therapeutic

33. Identifying Possible Punishers • One person’s punisher may be another’s reinforcer. • The only way we can tell is by its effect on behavior. • Measure the effects on the behavior

34. Example of an erroneous punisher “Our young daughter had adopted a stray cat. To my distress, he began to use the back of our new sofa as a scratching post. ‘Don’t worry,’ my husband reassured me. ‘I’ll have him trained in no time.’ I watched for several days as my husband patiently ‘trained’ our new pet. Whenever the cat scratched, my husband deposited him outdoors to teach him a lesson. The cat learned quickly. For the next 16 years, whenever he wanted to go outside, he scratched the back of the sofa.” (Reported in Behavior Analysis Digest, March, 1990).

35. Factors affect the effectiveness of punishers • Adaptation A punisher may lose its effectiveness if it was delivered frequently in a short period of time. • Conditioned punisher Saying “No!” will lose its effectiveness if it is not paired with another punisher.

36. Factors affect the effectiveness of reinforcers/punishers • Contingency A reinforcer/punisher should be delivered contingent to the target behavior • Immediacy A reinforcer/punisher should be provided immediately following the target behavior.

37. Example of erroneous contingency Former president Nixon and Henry Kissinger were sitting in the Oval Office discussing policy matters. King Timahoe, Nixon’s Irish setter, came in and began chewing on the rug. The president commanded him to stop. King Timahoe kept right on chewing. The president commanded again. More chewing. Finally, Nixon opened his desk drawer, took out a dog biscuit and gave it to King Timahoe. “Mr. President,” said Kissinger, “you have taught that dog to chew the rug.”

38. Consequences Group Activity 1. Describe the most recent behavior of an individual you are supervising. 2. Discuss with your partner what might be the consequences for the behavior.

39. ABC Model of PBS Antecedent Behavior Consequence

40. Antecedents • An antecedent is a stimulus that precedes a behavior and makes it more likely that the behavior will occur • When and where did the behavior occurred • What happened before the behavior occurred • Who was present when the behavior occurred

41. Examples of Antecedents • Tom tends to engage in self-injury behavior more often when Jane, a staff member, works on the shift, because she typically reinforces the behavior with attention. • Luke, a 7-year-old boy with Autism exhibited challenging behaviors at school and home. It appeared that much of Luck’s schoolwork was too difficult for him.

43. Antecedents • Behavior is ultimately controlled by its consequences, but antecedents also exert control. • Individuals with DD are vulnerable to the effect of a salient stimulus in the environment

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45. Antecedent: Biological Factors • Fatigue, pain, physical discomfort • Medical problems • Medication side effects • Changes in habits of eating, sleeping, bowel movement

46. Antecedent: Environmental Factors • Physical environment • loud, crowded environment • Space arrangement • Routines • Morning and evening grooming schedules • Evening activities (too much or too little) • Snack time • Schedule for chores

47. Antecedent: Environmental Factors • Workshop • Not much to do, boring, too much work • It is important to communicate between the staff at home and at workshop • If problem behaviors occur mainly at the workshop, or at home, it is an environmental issue.

48. Antecedent: Human Factors • Staff • Age, sex, race of the staff • Personality of the staff • Do not get involved in power struggle • Do not take individual’s behavior personally • Try to understand the individual’s perspective

49. Antecedent: Human Factors • Residents • Different habits • Language (the way they say things) • Dynamics among the residents • Other individual’s psychopathology

50. Antecedent: Human Factors • Family • Changes in family situation • Illness and death in the family • Frequency of contact • Visit schedules • How much the family is involved and how they communicate with the staff and the individual