PBS Plan for H A Summary Statement Competing Behaviour by mainskweeze

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									                                                                                                  PBS Plan for H   1

A. Summary Statement/Competing Behaviour Pathways Diagram
                                                             Transitions to new            Praise(dramatic,
Routines:                                                    subject                   →   sensory rich)
Transition and                                                                             gets preferred
Home Time                                                    Puts books in backpack        task/activity
                                                             and leaves
                                                                Desired Behaviour              Maintaining
                                                                                              Consequence
Autistic                   Asked to stop an activity         Refuses transition            Delays transition
-very limited      →       and transition to a new       →   (won’t move)              →   (escape)
verbal skills              activity                          Shouts (vocalizes)
-delayed
processing (10-            Home time                         Runs away
15 seconds)                When asked to clean up            Shouts “No Home!!”
Few choices                and get ready to go               repeatedly
Insufficient
predictability

Setting Event(s)            Antecendent Trigger(s)             Problem Behaviour               Maintaining
                                                                                              Consequence
                                                             Ask for one min. delay


                                                             Alternative Replacement
                                                                    Behaviour
B. Positive Behaviour Support Plan
Strategies that Make Problem Behaviours Irrelevant, Ineffective, and Inefficient
Setting Event Strategies       Preventative Strategies        Teaching Strategies      Consequence Strategies
   1. Use visual system           1. During                    1. Teach H to use           1. Provide brief but
      that enhance                   tasks/activities             visual system to            dramatic praise
      predictability,                use visual work              self-manage                 and/or stimulating
      choice, and                    systems to help H            tasks, activities,          item from survival
      autonomy                       predict tasks,               and school                  kit, contingent on
   • Visual schedule of              sequence, length,            schedule                    desired behaviour
      school day (daily              reinforcers and
      and weekly)                    transitions                                           2. Honour H’s want
                                                                                              or need when he
                                  2. Provide more              2. Teach H to use              uses language to
                                     support before               appropriate                 ask
                                     transitions or               language to
                                     major changes                communicate              3. In minor
                                                                  desire to                   incidences,
                                                                  avoid/escape                actively ignore
                                                                                              and redirect or
                                                                                              prompt H to use
                                                                                              language -honour
                                                                                              want/need

                                                                                           4. For major problem
                                                                                              behaviour, do not
                                                                                              allow H to escape;
                                                                                              assist through
                                                                                              transition
                                                                                                   PBS Plan for H   2

A. Summary Statement/Competing Behaviour Pathways Diagram
                                                              Does his work                 Praise(dramatic,
                                                                                        →   sensory rich)
                                                                                            gets preferred
                                                                                            task/activity

                                                                 Desired Behaviour              Maintaining
                                                                                               Consequence
Autistic                   Given a difficult                  Throws work on the            Escapes work
-very limited      →       academic task                  →   floor                     →
verbal skills                                                 Vocalizes
-delayed
processing (10-
15 seconds)
Few choices
Insufficient
predictability
Setting Event(s)            Antecendent Trigger(s)              Problem Behaviour               Maintaining
                                                                                               Consequence
                                                              Ask for a break


                                                              Alternative Replacement
                                                                     Behaviour
B. Positive Behaviour Support Plan
Strategies that Make Problem Behaviours Irrelevant, Ineffective, and Inefficient
Setting Event Strategies        Preventative Strategies        Teaching Strategies      Consequence Strategies
   2. Use visual system           3. During                     3. Teach H to use           5. Provide brief but
      that enhance                   tasks/activities              visual system to            dramatic praise
      predictability,                use visual work               self-manage tasks           and/or stimulating
      choice, and                    systems to help H                                         item from survival
      autonomy                       predict and                4. Use instructional           kit, contingent on
   • Visual work                     choose tasks                  procedures that             desired behaviour
      system                                                       match learning
                                  4. Offer choices                 style                    6. Honour H’s want
   2. Set up a                       within schedule                                           or need when he
      break/safe area                and curriculum             5. Teach H to use              uses language to
                                                                   appropriate                 ask
                                                                   language to
                                                                   communicate              7. In minor
                                                                   desires                     incidences,
                                                                                               actively ignore
                                                                                               and redirect or
                                                                                               prompt H to use
                                                                                               language -honour
                                                                                               want/need

                                                                                            8. For major problem
                                                                                               behaviour, do not
                                                                                               let H escape
                                                                                          PBS Plan for H   3
                                 Positive Behaviour Support Plan for H
                                              April 2006

Introduction

H is an active, hard working, enthusiastic and confident 10 year old boy who lives at home with his
family. His family includes his parents, and a 3 year old sister. He has an active relationship with his
grandparents who he stays with once per week. H has autism which has led to minimal verbal
communication and a 10-15 second processing delay, H also has mild cerebral palsy. This behaviour
support plan is necessary because H has been exhibiting a large number of problem behaviours
since he started school in September. The plan is based on a comprehensive functional assessment
and was developed in collaboration with H’s educational support team (teacher, TA). The plan
includes a summary of the functional assessment and a description of a multi-component positive
behaviour support plan. The focus of this plan is divided between completing work and transitioning
smoothly. There is much overlap but strategies specific to completing work have been italicized.

Caution

This plan is based on a comprehensive functional assessment that looked at the features in H’s life,
environmental and functional, in order to devise a multi-component plan to address the issues that
develop or maintain H’s problem behaviour. Reading this plan for the first time may leave the
implementers feeling overwhelmed. It is important to remember that it is not necessary to implement
all of the interventions at once. Select the most important or doable interventions to get you started,
over time you can add additional interventions to the foundation. If you concentrate on implementing
the setting even and preventative strategies, you will likely prevent many problem behaviours from
occurring.

                                   Functional Assessment Summary

Behaviours of concern:
  • Throws his work on the floor
  • Vocalizes
  • Noncompliance (when class is moving on to a new place, H won’t come, he sometimes runs
      away or shouts no!)
  • Self injury (H will make a fist and hit himself in the chin)

Functions of problem behaviour: The perceived function of most of H’s behaviours was to escape a
demand or task. Also, he’s not able to communicate verbally what he feels or is thinking; his yelling
lets us know his want or need has not been met.

Person/ecological/lifestyle factors: Several person-specific, ecological or lifestyle factors set the stage
for problem behaviours in which H wants to escape an aversive event.

   1. Autism. Due to his disability, H has very limited verbal skills and delayed processing of up to
      10-20 seconds. This makes it hard for H to communicate his knowledge and understanding to
      the people around him. H also struggles with his fine and gross motor skills. Each of these
      skill deficits make learning and doing new things difficult for H.

   2. Physical impairments. H has mild cerebral palsy which does hinder his physical movement in
      classes such as dance and P.E. For the most part his cp does not have a large impact on his
      learning.
                                                                                       PBS Plan for H   4

   3. Unsupportive environments. H does not do well in environments that:
                              a. lack structure and predictability
                              b. offer little to no choice
                              c. are loud and/or crowded
                              d. call for a lot of transitions
      In these contexts, H is more likely to engage in escape-motivated problem behaviour.

   4. Contexts which adult is busy/occupied. H has a TA to work with him 1:1 for three hours each
      day and she is able to work with him to minimize behaviours. During the other three hours of
      each school day the teacher is unsupported with a full class of 31 ten year old children.
      Patience sometimes runs thin which adversely affects H.

Triggers. There are two consistent predictors for the behaviour. All behaviours are triggered by either
a demand placed on him or because of a transition.
                                                                                       PBS Plan for H   5
                                   Positive Behaviour Support Plan

Functional Assessment Summary Statement

When H is asked to stop an activity and transition to a new activity or clean up and go home, H is
likely to refuse the transition by shouting, running away or refusing to move in order to escape the
transition or demand. This is more likely to happen because H has autism, limited verbal skills and a
10-15 second delay in processing. As well, H is given few choices and his day has limited
predictability.


Setting Event Strategies

   1. Use visual strategies. Use visual strategies to enhance predictability, choice, and autonomy.
   These include:
      • a picture/word sequence of H’s daily schedule at school
      • picture/word sequences of the steps in specific tasks, activities or routines at school
      • choice boards in which H is given the opportunity to choose a preferred task, activity or
         item
      • picture/word sequences of common positive contingencies such as: do work, then get
         break


Preventative Strategies

   1. During tasks/activities use visual work systems to help H predict tasks, sequence, length and
      reinforcers. Use the visual tools to help H deal with tasks and transitions that occur throughout
      the school day. A visual timer will help H to see how much time he has left at an activity; this
      will also help him prepare for a transition.

   2. Provide more support before transitions or major changes. Before a transition or a major
      change:
      • give H information beforehand
      • provide the information visually with a picture sequence
      • identify reinforcer in the new situation
      • use a positive contingency that motivates H to complete the transition
      • remind H he can ask for a one minute delay

   3. Offer choices within schedule and curriculum. When the TA is present to support H, allow him
      to use his picture/word sequences of the daily schedule to choose which activity he completes
      first (math or LA). When there is no TA, use the choice boards to allow H to choose within the
      task (LA time, handwrite or computer).


Teaching Strategies

   1. Teach H to use visual system to self-manage tasks, activities, and school schedule. Directly
      teach H how to use the visual systems set in place. Begin by walking through the visual
                                                                                         PBS Plan for H    6
      systems with H for each activity. Point out the upcoming transition and remind him of his
      options. As H becomes comfortable with using the visual systems, phase out the use of
      pictures to encourage H to look at the words rather than the pictures alone. If H expresses
      discomfort, reinstate the pictures until he is ready for a phase out.

   2. Teach H to use appropriate language to communicate desire to avoid/escape. Teach H to use
      verbal language to achieve his wants and needs. When teaching the use of language, model
      the language, prompt H to say it, and reinforce trying as well as progress and successful use.
      Language you will want to teach H is:
      • asking for a break or delay: “I need a break” or “one minute”
      • expressing refusal: “No thank you” or “do it later”
      • requesting an item or activity: “I want ________”

   3. Use instructional procedures that match learning style. During instruction, structure tasks and
      activities to match H’s learning style. Features of instruction that match H’s learning style are:
      • variety- H should do no more than 1 to 2 tasks at a time and they should be arranged in a
          clear and predictable sequence
      • visual/written prompts should be used to communicate tasks information
      • the presentation of task requests and demands should be done in a positive and
          encouraging manner


Consequence Strategies

   1. Provide brief but dramatic praise and/ or stimulating item from survival kit, contingent on
      desired behaviour. Give H descriptive praise for trying, progress and/or success. Behaviours to
      regularly praise descriptively include completing a task, executing a transition. When you see
      these appropriate behaviours give specific approval. (“Wow! You came to computers with the
      rest of the class!” “Great job, you asked for a break and then joined us for PE.”) In “survival kit”
      keep a variety of items that will provide stimulation for H, this may include candy or other
      sweets or an activity he likes such as play dough or snakes and ladders.

   2. Honour H’s want or need contingent on using language to ask. Give H a break when he asks
      for a break; a desired item or activity when he asks for it or attempts to verbally negotiate a
      reasonable compromise. Try not to give H a break or a preferred item /activity when he uses
      problem behaviour to communicate his want or need.

   3. For minor incidences, (refusal to work,) actively ignore and redirect or prompt H to use
      language and honour want/need.

      •   Actively ignore the precursor behaviour, redirect H to the task or situation, and when he is
          re-engaged, return to using positive, proactive support strategies.
              Example: H throws his work on the floor. “H, let’s finish this math sheet, I’ll help you.
              Great work! Now I’m going to help Melinda with her work, I’ll be back soon.”
      •   Prompt language that matches his want or need, prompt him to make the verbal request
          one or two more times.
              Example: H throws his work on the floor. “H, it looks like you need a break. Say, I need
              a break… thank you for asking. Take a break!”
      •   Use choice board to remind him of the choice he made or the choice he has within a
          situation.
                                                                                      PBS Plan for H   7

   4. For major problem behaviour, do not allow H to escape; assist through transition. When H
      escalates into moderate to high intensity problem behaviour to avoid or escape, it is best not to
      let H immediately avoid or escape the task or situation. Make the problem behaviour inefficient
      at getting his wants or needs met.

      •   Very briefly but clearly reprimand H, “that is not OK”
      •   Briskly put H through the task or activity steps he engaged in problem behaviours to avoid
          or escape- “we’re going to do this before you have a break”
      •   After briskly putting H through the task prompt him to ask for a break and then give him a
          break

Evaluation Procedures

Use implementation checklist to track
   • Level of implementation of behaviour support strategies
   • Child problem behaviour
   • The plan’s acceptability and importance to the school staff

Use the checklist two to three times/week during the first couple of weeks of implementation, then
gather this data at least once/week until improvements in the routine are acceptable and durable.
                                                                                                PBS Plan for H   8
                      COMPREHENSIVE POSITIVE BEHAVIOR SUPPORT PLAN
                               IMPLEMENTATION CHECKLIST
                                           H

Date/Week: __________________                Person using Checklist: _________________

Instructions: The purpose of this implementation checklist is to help you implement H’s positive behaviour
support plan. Before using the checklist, it is important to read the plan so that you will have a good idea about
how to implement the strategies below. On the right is a place to evaluate your level of implementation. 1
indicates that the strategy is not in place yet or that you were unable to do it. 5 indicates that the strategy is
well in place or that you used the strategy well. The checklist can be sued to remind you of what to do to
support H, help you plan what you will do to support H, and/or self-evaluate your and the team’s level of plan
implementation. The checklist also provides a place to assess levels of problem behaviour and to evaluate the
importance and acceptability of the plan.

                                                                            unable             doing
                                                                             to do              well
Setting Event Strategies

1.     Use a visual system that enhances predictability, choice and
       autonomy.
       • Visual schedule of school day                              1            2    3    4    5
       • Choice Boards                                              1            2    3    4    5

2.     Set up a break/safe area                                             1    2    3    4    5

Preventative Strategies

3.     Help H follow his schedule (i.e., remind him to look at it
       and praise him when he uses it to guide his activities
       during the routine)                                                  1    2    3    4    5

4.     Offer choices within schedule and curriculum                         1    2    3    4    5

5.     Provide H with more support before transitions or major
       changes                                                              1    2    3    4    5

Teaching Strategies

6.     Teach H to use visual system to self-manage tasks,
       activities, and school schedule                                      1    2    3    4    5

7.     Use instructional procedures that match learning style.
       e.g. math questions with pictures and computers                      1    2    3    4    5

8.     Teach H to use appropriate language to communicate
       desire to avoid/escape.                                              1    2    3    4    5

Consequence Strategies

9.     Provide brief but dramatic praise and/or stimulating item
       from survival kit, contingent on desired behaviour                   1    2    3    4    5
                                                                                                    PBS Plan for H   9

10.    Honour H’s want or need when he uses language to ask               1     2     3    4        5

11.    In minor incidences, actively ignore and redirect or prompt
       H to use language, then honour want/need                           1     2     3    4        5

12.    For major problem behaviour, put him through the routine
       or transition quickly                                              1     2     3    4        5


Level of Problem Behaviours

1.     vocalizing                                       never rarely sometimes often all the time


2.     noncompliance/defiance                           never rarely sometimes often all the time


3.     self injury/ runs away                           never rarely sometimes often all the time




Evaluation of Social Validity                                             disagree          agree


1.     The goals of the transition and academic routines are
       acceptable and important.                                          1     2     3    4        5

2.     The behaviour support strategies are useful and effective.         1     2     3    4        5

3.     The strategies are difficult to use.                               1     2     3    4        5

4.     H is successfully participating in the academic routine.           1     2     3    4        5

5.     We believe the support plan is successful.                         1     2     3    4        5
                                                                                         PBS Plan for H 10
                                          Implementation Plan

Introduction

This behaviour support plan is necessary because H has been exhibiting a large number of problem
behaviours since he started school in September. As H’s parents do not support the use of visual
materials, the strategies described will be used at school, not in the home.


Implementation support activities

Use implementation checklist to track
   • Level of implementation of behaviour support strategies
   • Child problem behaviour
   • The plan’s acceptability and importance to the school staff

Use the checklist two to three times/week during the first couple of weeks of implementation, then
gather this data at least once/week until improvements in the routine are acceptable and durable.

The TA will be given time in her schedule to create appropriate picture/word schedules for H. She will
be provided with models to aid this process. The TA and teacher will have time with the
interventionist to problem solve possible choices that H can make in his day. Once they have
reached consensus, two choice charts need to be made, one for the TA, and one for the teacher.

Both the TA and the teacher will have the opportunity to role play different scenarios until they feel
comfortable with following through on them themselves.

The TA and the teacher will meet each morning for 20 minutes before school to discuss the previous
day’s efforts and successes.


Implementers: Roles and Responsibilities

Because this support time concentrates on the school setting, the teacher and the TA are responsible
for implementing the plan. They will keep H’s mother advised of the plan and the ups and downs of
the process.

Timeline

It is important to remember that it is not necessary to implement all of the interventions at once.
Select the most important or doable interventions to get you started, over time you can add additional
interventions to the foundation. If you concentrate on implementing the setting even and preventative
strategies, you will likely prevent many problem behaviours from occurring.

It will take 2-3 weeks to set up the visual schedules and to devise a quiet work area for H. Once
these have been set up and are operational, the rest of the steps should be in place throughout the
next month.
PBS Plan for H 11

								
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