Get documents about "Module V _____
Shared by: 2CxzIx
-
Stats
- views:
- 9
- posted:
- 12/2/2011
- language:
- English
- pages:
- 45
Document Sample
Module V
______________________________________________________
Providing Positive Behavioral
Interventions and Supports
V-1
Module V Goal
_______________________________________________________
• To provide information about why
students with TBI have challenging
behaviors and to provide skill in
providing positive behavioral
interventions and supports.
V-2
Module V Learning Outcomes
______________________________________________________
• At the end of this module you will:
– Understand why students with TBI have
challenging behaviors
– Understand how to use functional
behavioral assessment to identify
interventions
– Be familiar with a range of positive
interventions and supports
– Be aware of medications used to control
challenging behaviors V-3
What challenging behaviors do
your students with TBI exhibit ?
______________________________________________________
• EXAMPLES
V-4
Why do students with TBI have
challenging behaviors?
_______________________________________________________
V-5
Behavioral control is complex
______________________________________________________
• Consider your own behavior.
• Do you ever have difficulty controlling
your own behavior? Why?
• Do you act differently in different
settings? With different people? On
different days?
V-6
Behavioral control requires the
intact and integrated functioning
of brain systems
_____________________________________________
– attention and memory
– regulation (physical and emotional)
– executive functions (planning and
anticipation)
– speed of processing
– communication skills
V-7
Students with TBI
_____________________________________________________
• Difficulty with new memory, working
memory, and attention: may not
remember instruction, rules or
consequences
• Reduced regulation: may not be able to
control emotions or reactions
– impulsivity
– disinhibition
V-8
Students with TBI (cont.)
_______________________________________________________
• Limited executive functions
– anticipation and planning: may not know
how to avoid difficult situations
– lack of awareness of others’ expectations
– difficulty taking the perspective of others
• Reduced speed of processing
– may need more time on questions/tasks
– may miss valuable information
V-9
Students with TBI (cont.)
_______________________________________________________
• Communication
– specific expressive and receptive
language limitations
– use of inappropriate behavior as a means
to communicate
– lack of awareness of social cues
• physical proximity
• gestures, eye contact, turn-taking
V-10
How do we address these
challenging behaviors?
______________________________________________________
• Functional behavioral assessment is a
continuous process (not a one-time event)
for identifying
(1) the purpose or function of the behavior
(2) the variables that influence the behavior
(3) components of an effective behavioral
intervention plan (BIP)
(DPI, May, 2000)
V-11
Functional Assessment of Behavior:
The Link to Intervention
_______________________________________________________
• Identify the problem
• Measure the behavior
• Identify slow and fast triggers
• Identify consequences of behavior
• Identify functions of behavior
V-12
Serena Example
1. Identify the problem
______________________________________________________
• State the problem clearly
• What is the problem the teacher is
having with Serena?
• Choose the most critical behavior to
address first
V-13
2. Measure the behavior
_______________________________________________________
• How frequently does the behavior
occur? With what intensity? For how
long?
• Why is it important to measure the
behavior?
V-14
3. Identify slow and fast triggers
_______________________________________________________
• Slow triggers (or setting events) are factors
that set the stage for the behavior
– Internal:
• brain injury
• mood, fatigue, hunger
– External: people, tasks, settings
• What slow triggers may influence Serena’s
behavior?
V-15
3. Identify slow and fast triggers
(cont.)
_______________________________________________________
• Fast triggers are events/stimuli that
immediately precede the behavior and
influence whether it occurs
• What fast triggers may affect Serena’s
behavior?
V-16
4. Identify consequences
______________________________________________________
What happens after the behavior that
influences whether it will occur again?
• Reinforcement: increases the occurrence of the
behavior
– positive reinforcement: desirable consequence
– negative reinforcement: avoidance of
undesirable consequence
• Punishment: reduces the occurrence of the
behavior
V-17
5. Identify functions of behavior
_______________________________________________________
• What functions (purposes) might the
behavior serve for the student?
(1) to gain access to social interaction
(2) to gain access to activities or objects
(3) to terminate or avoid unwanted situations
(4) to gain access to stimulating events
(5) to communicate feelings
V-18
Jerry Example
______________________________________________________
• Identify the problem
• Measure the behavior
• Identify triggers
• Identify consequences
• Identify functions of behavior
V-19
Developing the Intervention Plan
_______________________________________________________
“If the child’s behavior impedes his/her
learning or that of others, the IEP team
must consider, when appropriate,
strategies, including positive
behavioral interventions, and
supports to address that behavior.”
DPI, 1998
•
V-20
What are positive behavioral
interventions and supports?
______________________________________________________
• Positive interventions: Focus on
increasing skills and appropriate
behaviors using proactive strategies
• Supports: people and conditions that
facilitate the student’s use of skills and
appropriate behavior
V-21
Proactive Intervention
Strategies
_______________________________________________________
• Proactive: planned (and often
implemented) before the challenging
behavior occurs. The intent is to
prevent inappropriate behavior and
encourage appropriate behavior.
V-22
Reactive Intervention
Strategies
______________________________________________________
• Reactive: Implemented (and often
planned) after the challenging behavior
occurs. The intent is to reduce the
challenging behavior, but without
focus on replacement behaviors or
prevention.
V-23
Can we use the same
intervention strategies for
challenging behaviors that we
use with other students?
_______________________________________________________
• Why?
• Why not?
• In what ways do students with TBI
differ from other students?
V-24
Developing the Intervention Plan
______________________________________________________
• What is your goal? What do you want the student
to do?
• What triggers, consequences, and functions of
behavior will you address?
• What are the targets of intervention?
– environment
– instruction and curriculum
– teacher, peers, family
– student
• What specific strategies could be used?
V-25
Serena Example
_______________________________________________________
• What is your goal? What do you want
Serena to do instead of the problem
behavior?
– What is the skill or behavior you are
working toward?
– Is it realistic?
V-26
Serena Example
______________________________________________________
• What triggers, consequences, and
functions of behavior do you need to
address?
V-27
Serena Example
______________________________________________________
• What are your targets of intervention?
– Environment
– Instruction
– Curriculum
– Teacher
– Peers
– Family
– Student
V-28
Developing Positive Interventions:
Five Approaches
______________________________________________________
1. Prevent inappropriate behavior
2. Increase appropriate behavior
3. Decrease inappropriate behavior
4. Use communication and group
strategies
5. Increase use of self-management
strategies
V-29
Serena Example
1. Prevent inappropriate behavior
_______________________________________________________
• What could be done to address the
slow and fast triggers that influence
Serena’s behavior?
V-30
Antecedent Factors that Might
Influence Students with TBI
________________________________________________________
Environment Task Demands
• Class size • Expectations
• Consistency of staff • Rate of success
• Student-staff ratio • Memory demands
• Supervision • Time limitations
• Noise • Feedback frequency
• Lighting • Support available
• Space • Stimulation V-31
Common Classroom Antecedent
Control Techniques
_________________________________________________________
• Classroom rules • Systematic instruction
• Classroom routines • Modeling
• Classroom schedule • High rates of success
• Positive student- • Appropriate
teacher interactions educational program
• Positive student- • Appropriate, engaging
peer interactions activities
• Clear expectations • Advance planning V-32
Serena Example
2. Increase appropriate behavior
_______________________________________________________
• Teach alternative or incompatible
behavior
• Reward (positively reinforce)
appropriate behavior
• Model appropriate behavior
• Prompt or cue appropriate behavior
• Shape appropriate behavior
V-33
Serena Example
3. Decrease inappropriate behavior
_______________________________________________________
• Maintain focus on positive interventions
– Use redirection
– Establish stimulus control
– Reinforce alternative behaviors
– Reinforce incompatible behaviors
– Extinction (when safe)
V-34
Serena Example
4. Communication/group strategies
_______________________________________________________
• Teach appropriate communication
skills such as listening, turn-taking,
and empathy
• Use group interventions, such as
support and social skills groups
V-35
Serena Example
5. Self-management strategies
_______________________________________________________
• Goal setting
• Self-monitoring
• Self-evaluation
• Self-reinforcement
• Relaxation/rest
V-36
Jerry Example
_____________________________________________________
• What is your goal? What do you want the student
to do?
• What triggers, consequences, and functions of
behavior will you address?
• What are the targets of intervention?
– environment
– instruction and curriculum
– teacher, peers, family
– student
V-37
Jerry Example
What specific strategies will you
use?
_______________________________________________________
1. Prevent inappropriate behavior
2. Increase appropriate behavior
3. Decrease inappropriate behavior
4. Communication and group strategies
5. Self-management strategies
V-38
Stages of Recovery and
Intervention Use
_____________________________________________________
• Challenging behaviors differ across
early, middle and late stages of
recovery
• Intervention strategies and supports
must match the needs and abilities of
the student as (s)he recovers
V-39
Examples of Specific Strategies
to Use With Specific Problems
_______________________________________________________
• Examples of strategies to use with
specific problems are presented on the
next several pages in your manual.
• Note that these are just examples. The
specific strategies you develop will
depend on the unique characteristics of
the student, teacher, and context.
V-40
Evaluate the Plan
______________________________________________________
• Don’t assume you are finished when
you put the plan in place
• Evaluate how well your interventions
are working
• Keep up frequent communication with
all stakeholders: student, parents,
teachers, therapists, administrators
V-41
Medications with Students with
Challenging Behaviors
______________________________________________________
• Medications are sometimes used to
help manage the behaviors of students
with TBI
• It is critical for school personnel to be
aware of the potential side effects of a
student’s medications
• Several medications are described on
the following pages V-42
Crisis Intervention
______________________________________________________
• When a student’s emotions and
behavior are escalating
– adaptive
– tension
– emotional distress
– physical distress
– recovery
V-43
Understanding Stages of
Challenging Behavior and
Stages of Support
• Guidelines
• Videotape (optional)
V-44
End of Module V
V-45
