Addressing Challenging Behavior - Part 1

Video Transcript

Hello, Chris here again. Thank you for joining us today for part one of Understanding and Addressing Challenging Behaviors of Individuals with Complex Needs webcast series. As you heard in the intro, the webcast is a series.

Since this is part one, you're at the right place. We will be building your knowledge step by step through each of the webcasts. Today, we will start by looking at defining behaviors. Don't forget, as we talked about in the intro webcast, it's OK to pause the webcast and review the handout, or go back over it and play a section over again.

This process takes time to learn. And sometimes we need to hear or see it several times to really get it. So take the time you need. And now, let's get started.

Behavior. We have all had experiences with individuals that exhibit challenging behaviors. This is what it can look like. It is upsetting to the person, as well as those around them. So we want to help people not get to the point of frustration, being upset, or melting down.

You probably already know there are no canned solutions for challenging behaviors, no quick fixes. Individualized interventions are the most successful and respectful ways to support people to change their behavior. During this webcast series, you will learn a process that can be used to look comprehensively at what is underlying and driving behaviors to occur and to continue.

So, what is behavior? Basically, it is an action that you can see and measure. Expected behavior is often what we focus on when we delve into this subject. There are expected actions or behaviors for certain environments, and that can even change based on the person's age. In addition, different factors can influence behavior such as demands, or rewards, or even a person's neurology, or previous life experiences.

So, let's think about how these behaviors can develop. Behavior is like an iceberg. An icebergs sits both above and below the water line. Only a small piece of the berg is actually easily in view. As one gets close-- and sometimes you must get very close-- you start to see that there is a huge piece of ice under the surface that holds the tip out of the water and in plain sight.

Be careful though. You must respect that chunk that lies below the surface. Otherwise, you could find yourself in a dangerous situation.

Behavior, again, is much like this iceberg. We can easily identify the intense behaviors that disrupt and might even be dangerous, but we often miss the emotions and situations that lie below the surface that drive that behavior at the tip of the iceberg. Those situations and emotions under the water, below that surface, are the ones that we need to attend to.

Those issues are the ones that we need respect and intervention. Addressing those issues can prevent that tip from breaking through the surface and exploding. This iceberg concept will show up several times as we work through these materials. We hope this visual will help you quickly think about, and explain to others, the importance of attending to all aspects of a behavioral situation.

So what do we do when someone exhibits a challenging behavior? People do a variety of things. Sometimes we try everything we know at the same time. We throw every intervention we have at the behavior, hoping that just something will work. But sometimes it makes very little difference. And if the behavior does improve, we don't know what part of the plan actually was beneficial.

On the other hand, we might try consistently using one thing at a time, trying that one go-to strategy and, again, that challenging behavior may still be there. And sometimes we cannot even decide if the behavior is one that we need to specifically attend to or address, or that the person might even need a plan for.

For one person in one place, it as a problem. But for someone else in another place, it may not be a problem at all. So let's talk about what is included in the spectrum of challenging behavior. There are different levels of behaviors that can be concerning. It can start with just annoying habits, which might be chewing skin around your fingernails or laughing loudly when no one else is laughing.

Next might be things that just drive me crazy, such as someone tapping on a desk or [CLEARING THROAT] clearing their throat continuously. These can drive you crazy. These two levels, though, may cause some to intervene, but the consequences of these situations are just not as great as those for the next several levels.

Behaviors at the next level are described as those that limit opportunities-- like pacing, jumping, invading others personal space, or looking into others personal belongings. These behaviors could limit when and where a person may be welcomed. As we move up the continuum, there are behaviors that actually prevent learning, which can include getting stuck on a topic, refusing to do your homework, or even sleeping in class.

And finally, we might see dangerous and destructive behaviors such as hitting, kicking, running away. These are the most serious and truly impact the person's ability to participate in a full and meaningful life. Interestingly, the same behaviors in different environments may appear in different places on the challenging behavior spectrum.

For example, entering someone's personal space in the home setting may just be considered annoying, while the same behavior in a work environment will limit opportunities, keep the person from learning new work skills, or may even cause him to lose the job. Does that make sense? If not, you can always pause the video, discuss this concept before moving on.

Next, we will talk about how we can decide when a behavior needs intervention. Here are some questions a team may consider when trying to decide if the behavior is a problem. As you read these, you see that behaviors that interfere with a person's ability to engage in important social and learning activities is a priority.

Notice that this is not just about learning in a classroom or being able to do a job, but also about the social impact behavior can have on the person. Ultimately, these behaviors have the greatest impact on the individual's quality of life, which warrants the team's close attention. That team might include the education personnel who work with that student, or the family group who assist the individual in the home or in the community, or a vocational team who support an individual what their job.

The team, which may also include the individual and the family, needs to examine the behavior in question and decide together if the behavior needs to be addressed. So why does there need to be a consensus? We believe if there is not agreement, the team will not be working together to provide the appropriate supports for the individual.

This does not mean that the team will not have different ideas during the planned development. What it does mean is that you have a group of people that agree that it is important to work together to create a support plan, and then agree to implement the plan as designed. Most of us have experienced the frustration of working in a silo by ourselves and have seen the lack of progress that results. Input and participation from all team members really is essential.

Your team might include some of the members listed on this slide. In the school setting, this team would need to consider the positive interventions and supports that need to be in place to help improve the identified behavior. You will notice that a discipline system, or a removal of privileges, or sending the person home from work is not the first thing mentioned here. Instead, it says, consider the use of positive behavioral interventions and supports, and other strategies. That's going to make even more sense as we move through the process of how to build this plan.

So, do you think you understand how to put a team together? And can you decide if a behavior needs intervention? If yes, let's move on. But if you are still digesting this material, hit that pause button or back the webcast up a bit, and review the information.

Now we are moving on to talk about positive behavior. Positive Behavior Interventions and Supports also known as PBIS. As we touched on in the intro video, PBIS is a school-wide system that talks about three levels of supports. The primary level is a support that will be provided for all students and staff across the settings. These supports address the needs of about 70% or 80% of all the students.

For the 15% to 20% of student's needs not met by primary prevention, we move to secondary prevention. These might include reinforcement systems or a small group instruction. And for those 5% to 10% of student needs not met by the primary or secondary supports, there are specialized individualized systems set up to address their unique needs at the tertiary level.

Keep in mind that students are not assigned to a level, but may need different levels of supports in different environments and at different times in their lives, at any of the levels. This webcast series is primarily addressing students who may, at times, need the supports offered at tier three.

The six principles of PBIS talk about evidence-based practices or EBP, use of data to make behavioral decisions, making changes in the environment to try to prevent a behavior from occurring, teaching social competence and social skills, making sure the evidence-based practices are implemented with consistency across people and environments, and that continuous monitoring occurs.

As we mentioned in the intro webcast, you will hear about each of these principles addressed as we work through this process. So, let's go back to the iceberg for a minute. We want to talk about the difference between a crisis plan and a behavior plan.

There are times that behaviors get ahead of us, and we find ourselves at the top of the iceberg in a crisis situation. At this time, the team needs to have a crisis plan that keeps every one safe and allows the individual to de-escalate. What we might not recognize is that many things are happening below the surface building towards the top of that iceberg

Positive behavior support plans are proactive and address needs below the surface such as the challenges listed here. We will be talking about how to make a proactive, positive behavior support plan the teaches a new skill, rather than just a reactive crisis plan. This webcast series is going to help you learn a process that uses Functional Behavior Assessment or FBA. We will teach you steps of a process that will lead to developing an individualized positive behavior plan. And be aware using a functional approach to understanding behaviors is a practice that has been found to be effective and evidence-based for individuals of all ages. This is not just for kids.

Based on your background and experience, some of this may be familiar. However, in order to assure that we are all on the same page, we will review vocabulary throughout the webcast. For ongoing challenging behaviors, a Functional Behavior Assessment, FBA, should be conducted to obtain a thorough understanding of the behavior and the circumstances around it.

The acronym ABC is used to represent antecedent events, or those that occur before the behavior; behavior of concern; and then consequences to the behavior, or those things that occur after the behavior. In school settings, a BIP, or Behavior Intervention Plan, would be developed based on this information.

For our purposes across environments, we will be showing you how to develop a positive behavior plan. In the next couple of webcast we are going to look at each of those ABC areas to help complete the iceberg. This provides the basis for completing a support plan that is individualized and targeted. We will first show you the big picture of the process, and then we're going to dig deep into defining the target behavior.

These next two slides represent forms that you are finding included in your packet. And you may download these forms. You will be using these forms throughout the webinar series. At this point, it may look a little bit overwhelming or confusing-- I imagine it can-- which is why the series takes the viewer step by step through each section.

In section one, you will summarize the individual's challenges that are associated with a specific behavior. Section two allows you to summarize the issues that you've discovered are driving or influencing that behavior of concern. Section three, we'll summarize the individual strengths that can be used in the support plan. Can't forget those.

In section four you will brain storm new skills that need to be developed to support the individual to change his or her behavior. And then in section five, you will identify what we will call replacement and related behaviors or skills. These will be the new skills that will be taught to change that targeted behavior.

And finally, section six will list the identified and associated interventions to support change, teach the new skills, and replace those challenging behaviors. For those of you who like to know where you're going, you can heave a big sigh of relief. And for those of you chomping at the bit, ready for the next step, let's get going.

We now know talking about defining behaviors as our next step. So let's start with the B in the ABC model, behavior. This is what we can see and observe. It can be measured or counted. All team members understand the description of the behavior. That's very important.

We are going to talk about defining the behavior. Why? Because if we don't get this right up front, the rest of the plan will be built on inaccurate information. Defining the behavior accurately is the foundation of that plan. The behavior description needs to be recognizable by anyone who reads it.

Here are words we sometimes use to try to describe challenging behaviors. We might say tantrum, aggression, frustration. Are they observable? Well, actually not really.

Can you measure them? Probably not as they are written here. They really aren't specific enough to count. Do we know where these happen? No, not really.

These examples could mean different things to different people. How about this phrase, Ryan runs and screams? What is considered screaming here? Does that mean anything over a conversational tone? When it's loud enough to interrupt? Or when my head starts to split?

Is it something that is important in all settings or not? What is running? Is it only running if I can't catch you? OK, while I exaggerate somewhat, you can see we can't all agree on what screaming and running is from this description. You really need to expand on it, make it measurable.

How about these behaviors, are they observable? Yes, I think so. For the most part, you can measure these. We have more specific information here. We can measure them.

Do we know where these happen? That might need to be defined further. And this description of Ryan's behavior would be observable and measurable by most anyone watching it.

Let's take another look at another example. Meet Molly, this is our case study for this webcast series. Molly is a young child that is attending her first year of organized education. She has been described as being very cute and very engaging, until things don't go her way.

She likes many aspects of the kindergarten class but certain activities seem to be a problem. One of those is circle time. Circle time is very academic based. It's not her favorite time. And that seems to be the time when she becomes most unhappy.

Activities at the table, hands-on activities, music, playground, these are all happy times for Molly. She likes a schedule. And she generally wants the schedule to be on her time. Although Molly is verbal, she seems to have trouble finding words to tell the teachers when she starts to get upset, and can't actually tell them what's wrong. Instead she screams, and she kicks, and she hits.

So, what do we know about Molly's behavior? She struggles with circle time and transitioning with the classroom schedule. Molly enjoys hands-on on activities, music and behavior.

Let's look at Molly's challenging behavior in the context of the iceberg. Molly screams loudly enough to interrupt the teacher's instruction to class. Is this clear? Yes, I think so.

Would most people be able to identify the same behavior. Yes, I think so. Could we measure it? Yes, we could.

For example, we could count occurrences or even time how long it lasts. For other case study examples, check the folder in the download. There are examples of Molly in the home setting. And an example of a gentleman we will call Joe. He's an older student.

If you are a parent or family member, you may want to have the case study of Molly in the home setting available to refer to as you work through the webcast. If you are an educator or someone working with an older student, you may want to have the case study of Joe available to look at as we work through the series.

Because it is so important to the process, we are going to look at a couple more examples to clarify defining target behavior. Which of these definitions is better? In the first one, what does non-compliant mean? What does refuses look like? Refuse could be screaming no, could be sitting still and doing nothing, or it could be running out the door, or it could be pushing materials off the desk, or any number of things.

What does work mean? Any kind of task-- worksheets, writing? This doesn't really give us that video-like description we're looking for. In the second one, we can see exactly what happens. Can't you picture a staff member asking Johnny to do a task, and he just climbs under his desk and sits there.

And notice that we are already drawing conclusions about why the behavior occurs when we say that Johnny is angry. Non-compliant and refuses really does not describe what Johnny is doing. And it leaves it wide open for interpretation.

So we want to just describe what we see. The second definition is stating fact-- what happens and when. At this point in the process, we want to be clear, descriptive, and keep an open mind as to why the behavior is happening.

So, how about these definitions? Do you like the first one or the second one? Yep, it's the first one. Again, we can see what Tomas is doing through the words, and it's just the facts.

In the second one, the words won't and gets mad are already starting to draw conclusions. Do you find that the better, clearer definitions also sound more respectful towards the individual? Yes, I think so. The descriptive definitions focus on the behavior and not the person or the function of the behavior. We will talk more about function in the upcoming webcast.

Here are some factors to consider as you complete your assignment, before watching the next webcast. Work towards that clear, measurable, defined target behavior. Create a definition that someone could see in their head. Be specific and be concrete.

To help you practice this process, we have included a file of forms you can fill up with information about your individual or family member. Before the next webcast, choose and define a challenging behavior to target for your individual. Describe it in a way that is observable and measurable.

Try reading it to others, and see if it's clear to them as well. Remember, if you get stuck, just replay the webcast or a section of it, and see if you can answer your question. So, thanks for attending this first webcast. We will see soon for part two. And don't worry, they're not all this long.

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Gain an understanding of how to define behavior, the importance of teaming, positive interventions, and how to complete the forms for this series. This video segment is loaded with information. As you learn to define a specific challenging behavior and to look comprehensively at what is underlying and driving the behavior discover the impact of the emotions below the surface, that are often missed. This segment discusses the importance of a team approach, provides an overview of positive behavior supports (PBIS), and an overview of functional behavior analysis (FBA). It also explains forms used in the process. Whew!

View all the Documents in this series here