Function Based Treatments for Problem Behavior by dffhrtcv3

VIEWS: 9 PAGES: 46

									Understanding and Managing
     Problem Behavior

            P R E S E N T E D B Y:

     LY N S E Y J A C K S O N , B C A B A
     MELISSA LIOTTI, BCABA

    U N I V E R S I T Y O F H O U S TO N
              CLEARLAKE

  A P P L I E D B E H AV I O R A N A LY S I S
                 PROGRAM
                   Presentation Overview

 Common problem behaviors and their effects
 The role of the environment
 Common “functions” of problem behavior
 Methods for determining which function the child’s
  problem behavior is serving
 Strategies based on the results of your assessment
     Recognizing some common maladaptive strategies that MAY be
      maintaining the problem behavior
     Some adaptive strategies that can help reduce problem behavior
                      Problem Behavior

 Some common types:
    Aggression, self-injury, property destruction, disruption,
     elopement, stereotypy, etc…


 Some effects:
    Risk of physical harm, lack of social development leads to
     isolation, skill acquisition deficits, independent skill deficits
     (long term care), family stress


 So why does problem behavior occur? Why do they do it?
                Why Do They Do It?

 Problem behavior is probably the easiest way for
 children who lack speech to communicate
 Problem behavior is usually a learned behavior that
 serves a purpose for the child (it gets them what they
 want)
 Behavior is related to specific antecedents (what
 happens before the behavior) and consequences (what
 happens after the behavior) in the environment.
 Understanding a child’s behavior = determining what
 the "function” or “reinforcer” for the behavior is
                 Why Do They Do It?


 The relevant antecedents or consequences often involve the
  behavior of others (e.g., reactions to the problem behavior).
                  Understanding Behavior

       Antecedent  Behavior  Consequence

 Antecedents:
  Occur immediately before a behavior
  Potential “triggers” for problem behavior

  Can affect the frequency and intensity of behavior

  Examples:
    Difficultor ‘excessive’ tasks
    Denial of desired items or activities
                 Understanding Behavior

       Antecedent  Behavior  Consequence

 Consequences:
  Occur  immediately after a behavior
  What the behavior “gets them”- reaction, items, etc.

  Affect the likelihood of the behavior occurring again in the
   future
  Examples:
             in the form of stern looks or reprimands
    Attention
    Removal of difficult tasks
      Main Functions of Problem Behavior


 Attention!

    Children are quick to learn that engaging in problem
     behavior can get them lots of attention!

    Remember- any form of attention can be desirable to the
     child- even stern looks, reprimands, and restraint!

    “There’s no such thing as bad press.”
      Main Functions of Problem Behavior


 Access things they like!

    Problem behavior can get them things they want

     Problem behavior can get them things that have been
     restricted or denied (“5 more minutes!”)
       Main Functions of Problem Behavior


 Escape or avoid things they don’t like

    Children are quick to realize that misbehavior will result
     in getting them out of things they don’t like

    This may happen when a child is placed at a desk with
     work, asked to help with chores, is told it’s time for a
     bath or bed, or is in the presence of aversive events (loud
     environments, close proximity to others, etc.)
       Main Functions of Problem Behavior


 Sensory stimulation

    Most difficult behavior to treat

    The consequences are not provided by anyone else (child
     engages in the behavior when alone)

    Access to pleasurable stimulation (e.g. rocking)
  So How Do I Determine the Function?

 Indirect Assessments
   No direct observation

   Ask people about the behavior

   Easy and fast but potentially inaccurate/biased



 Descriptive Assessments
   Direct observation over several sessions/days

   Tracks behavior as it naturally occurs

   Tracks the relevant antecedents and consequences for each
    instance of problem behavior
               Descriptive Assessments

 Help us..
   gather information/data through direct observation

   evaluate and interpret the data, look for patterns/commonalities

   develop a behavior intervention plan (BIP)


 Some common descriptive assessments:

     Narrative ABC Recording

     Structured ABC Recording
               Narrative ABC Recording

Setting     Antecedent (A)              Behavior (B)         Consequence (C)

6:30 p.m.   John was playing with       John hit the floor   I walked back into
2/16/10     his blocks on the living    with his hand and    the kitchen.
            room floor. I told him it   screamed.
Living rm
            was time to put them
John        away to eat dinner.
Mom
1:32 p.m.   I was playing game          John walked into     I said “John! We
2/17/10     with Amy at the kitchen     the kitchen and      don’t throw shoes!
Kitchen     table. John was             threw his shoes      Why did you do
John        playing with his toys       across the room.     that?”
Dad         alone in the other
Amy         room.
             Structured ABC Recording
Hit others                                       
Throwing                                



                                                  
                                                       2


                                                         2
                                                        1
                           
                   

                                   
                                                    3
                                     
                           

                                                         2
                                         

                                                      1
               

                   
                                         
     Now What? Interpreting the Results


 Look for a pattern
  Common antecedents?
  Common consequences?



 Determine the possible function
  May   not always be the same across behaviors and
   situations
       A                 B                  C           Poss
  (antecedent)       (behavior)       (consequence)    Function

 Mom on phone                          Mom gets off
                    Dan hits sister                     Access
   (low attn)                         phone - scolds
                                                       attention
                                          Dan

  Teacher tells      Nicole yells     Teacher takes
Nicole to put her    and throws       the plates to
dish in the sink    herself on the    the sink         Escape
   (demand)             floor         instead

 Teacher says         Dan bites       Teacher says      Access
computer time is    himself on the    “Ok! 2 more
   all done                                              items
                        hand          minutes!”
    Tom              Beth     03/03/10




                     
Hit others
                 
Throwing
                          
             




                     




                     


                     
SO ONCE YOU SUSPECT
 A FUNCTION, HOW DO
    YOU TREAT IT?
Managing Problem Behavior


              Decrease
                         Attention
 Problem                 Tangible
 Behavior                Escape

              Increase
                         Attention
Appropriate              Tangible
Behavior                 Escape
 Strategies for Attention-Maintained Problem Behavior

 Behavior occurs to get attention


     Catch your child being good

     Use Planned Ignoring

     Teach Your Child A Better Behavior




                                                   29
Strategies for Attention-Maintained Behavior

             Catch Your Child or Student Being Good

 Give attention often (for example, every 5 minutes).


 Give attention as soon as you see any good behavior.


 Give enthusiastic attention.


 Don’t give attention if problem behavior just occurred.
Strategies for Attention-Maintained Behavior

                         Planned Ignoring
 Ignore only behaviors that are not harmful.


 Ignore behavior immediately.


 Make ignoring obvious.


 If giving attention, immediately remove it.


 Still catch your child being good!
Strategies for Attention-Maintained Behavior

                   Teach Better Behavior

 Identify the specific behavior you want to teach




 Practice with your child or student
 Teaching the Better Behavior - Attention

                    Set up for Practice

                     Wait 5 Seconds
              yes                     No

Provide Attention                Model or Physically Guide
                                     to do Response

                                      Child does behavior
                                        with assistance

                                          Provide Attention
 Teaching the Better Behavior - Attention

                    Get on the phone

                     Wait 5 Seconds

       Tapped you on                   Did not tap you
       The shoulder                    on the shoulder

                                  Take child’s hand and
Provide Attention               show him or her how to tap
                                      your shoulder


                                        Provide Attention
 Strategies for Tangible-Maintained Problem Behavior


 Behavior occurs to access preferred items/activities

    Do not give preferred items when problem behavior occurs

    Teach your child a better behavior




                                                                35
Strategies for Tangible-Maintained Problem Behavior

                  Teach a Better Behavior

              Place car for your child to see

                      Wait 5 Seconds

 Says approximation               Does not say anything
       to car
                                       Direct your child to
                                            “Say Car”
Give car and praise

                                          Child says “car”

                                         Give car and praise
Strategies for Escape/Avoidance-Maintained Problem
                      Behavior

 Behavior occurs to avoid or get out of disliked activities
 or instructions

    Use Effective Instructions

    Use Three-step Prompting

    Reinforce Instruction-Following

    Teach a Better Behavior

    Additional Strategies to Prevent Problem Behavior

                                                          37
Strategies for Escape/Avoidance-Maintained Problem
                      Behavior


                  Use Effective Instructions
 Instructions should be:
     Simple

     Clear and Specific

     Short

     Presented when your child is paying attention
 Strategies for Escape/Avoidance-Maintained Problem
                       Behavior

                          3-Step Prompt Sequence
           (To be used when your child is not following a direction)
1.       TELL your child what to do:
     •    Give clear instruction
     •    Wait 5 seconds
2.       SHOW your child what to do:
     •    Model the exact response OR provide gestures that indicate what you want
          (e.g. point to object)
     •    Restore environment
     •    Tell your child, “now you do it.”
3.       HELP your child do it:
     •    Take your child hand-over-hand through entire response and say, “you
          need to _______.”
Strategies for Escape/Avoidance-Maintained Problem
                      Behavior

              Reinforce Instruction-Following

 Follows instructions = lots of reinforcement!


 Reinforcers could be one or more of the following:
    Break from task

    Social: praise, hugs, tickles, high-5

    Material: toy, edible, favorite activity
Strategies for Escape/Avoidance-Maintained Problem
                      Behavior

                 Teach a Better Behavior
              Say, “Clean up the blocks””

          After 5 seconds of following instruction

   Child gives you                  Did not give you
   “break” card                     “break” card

                                   Take child’s hand and
Provide a break                    physically guide them
                                     to hand you card

                                       Provide break
Strategies for Escape/Avoidance Maintained Problem
                  Behavior (cont’d)

         Additional Strategies to Prevent Problem Behavior

   Provide choices or more preferred activities when possible

   Make the situation/event less aversive by manipulating
     Task length/difficulty
     Novelty of tasks
     Noise
     Crowding
     Schedule




                                                                 42
    Strategies for Problem Behavior Maintained by
                  Sensory Stimulation

            Arrange an “Enriched Environment”

 Identify highly preferred activities and objects


 Rotate/activities often and encourage engagement
 Managing Behaviors is the Hard Part, Right?

 Sorry!


 The really tough part:

     Doing the procedures correctly
       Follow your plan exactly


     Doing the procedures consistently
       Don’t make exceptions, use the plan every time



                                                         44
       Barriers to Implementing Procedures

 Sometimes behavior will get worse before it gets better!


 Some settings not conducive for running the program
      Plan ahead to prevent problems

 More effortful to do procedure than to give in


 Adult behavior is just as sensitive to reinforcement as
  child behavior…the vicious cycle!
        Break the Cycle!

            Determine why
 Antecedents - Behavior - Consequence

              Decrease
                             Attention
 Problem                     Tangible
 Behavior                    Escape

              Increase
                             Attention
Appropriate                  Tangible
Behavior                     Escape

								
To top