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Addressing Challenging Behavior - Part 10

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Welcome back for the final steps in developing your behavior plan. Wendy here with you today.

As you know by now, we believe you've completed Webcast One through Nine, and you're slowing down when you need to process the information presented. If you're working through the process with an individual you support, you identified replacement and related skills in Section Five. Remember as you work through this process, what you fill out on these forms can and probably will change and be added to, as you talk with team members and start using what you think is going to help support behavioral change and make adjustments.

As we continue working on the process, we're going to discuss interventions and strategies based on the information you've gathered so far. You will be developing an initial intervention plan for the replacement skills you have identified, and a secondary plan for the related skills. The plans will include strategies and interventions based on the challenges, strengths, and interests of the individual that you've developed in Sections One, Two, and Three so far. The intervention plans will include strategies that address the underlying issues you summarized in Section One; the strengths, interests, and motivations summarised in Section Three; and the skills identified in Sections Four and Five.

You'll now begin to see why all of the work you've done up to this point was necessary, and how to pull that knowledge together in a cohesive manner. There are two options for the behavior support planning form in your packets. This is one that has half-page sections for the intervention plans under the skills you identified in Section Five. And this is the second option, which is in the optional forms that gives you a full page for the Replacement Skills Intervention Plan, and then another sheet that's a full page for the Related Skills Intervention Plan. Whichever one works for you is fine.

Next we'll discuss what the interventions might target. Some might target the stress that can increase the intensity or frequency of behaviors. For Molly, that would mean targeting when she didn't have enough personal space, was involved with less structured activities, or couldn't complete an activity she had started before moving on in her schedule. Can you see how these things would have been stressful to her?

Some interventions may address changing setting events that make the behavior more likely to happen. For Molly, that involves her personal space and schedule, and routine changes. Changes in these events will lessen the chance of the behavior occurring. Other interventions may be directed at teaching needed skills. For Molly, that includes coping skills, communication skills, academic skills, and social skills. These skills will help her be successful in circle time and decrease the need to escape or avoid it by using her targeted behavior. Can you see how all of the information gathered so far is starting to fit together and form the foundation for the behavior plan?

We talked in an earlier webcast about reinforcement as a factor that can increase the challenging behavior as part of the ABC chart. Now we're going to talk about how reinforcement can help to teach the new skills, as part of the interventions. Let's examine reinforcement. We're now talking about those events that occur purposefully and encourage a person to continue or repeat a behavior.

Here's an example. Maybe you have a system for earning time on the computer, or earning money to increase homework completion without a fight. That would be purposeful, planned reinforcement. As you develop the intervention plans to teach new skills, you will need to plan for purposeful reinforcement to support teaching the new behaviors. What do we need to remember about reinforcement? It has to be chosen to fit the individual.

Here's a scenario. Every time I take out the garbage, you give me coffee. But I don't really like coffee, so I'm not that inclined to take out the garbage. Now if you offered me chocolate, that garbage would go out several times a day because I love chocolate. So we must do reinforcement inventories and know what we're offering is a desired reinforcer.

We have to reinforce tiny steps towards those new skills and behaviors frequently. This is hard work for the individual, and we want to support the efforts. Reinforcement systems need to be taught to staff, caregivers, and family members so everyone's carrying out the system the same. The reinforcement should follow the targeted behavior immediately, so the individual knows for sure that's what he or she wants to repeat.

Reinforcement needs to help show a change in behavior. If the behavior isn't improving, then the team needs to examine if the reinforcer is no longer desired, isn't following the behavior closely enough, isn't happening often enough, or isn't being given consistently in accordance with the plan.

As a review, there are several types of reinforcement. Tangible reinforcers are items the individual enjoys. Token reinforcers may be boards or cards that show how many tokens need to be earned before receiving a reinforcing activity or object. Activity reinforcers are specific amounts of time doing a chosen favorite activity, like playing a game, watching a video, or computer activities. And social reinforcers, which might be time with a chosen favorite adult or peer, or maybe time doing something enjoyable in the community. We'll talk a little bit more about reinforcement as a part of the tool in the final webcast.

We're going to review what we know about Molly so far, and how that information's leading us to the strategies in her intervention plan. Her team kept a lot of information in mind, as they developed her intervention plans to address the targeted behavior. Remember how the antecedents, reinforcing consequences, and function of Molly's behavior led to identification of the missing skills for Molly? Her team took a look at her strengths and challenges, too. All of this information is going to feed into her intervention plan.

In the downloadable packet, you can find this sheet of guiding questions for developing an intervention plan in the guiding documents packet. These are not all the questions you need to ask and discuss, but they're a starting point for you to start working on that intervention plan.

This is Molly's plan on the half-sheet intervention form. The left side's addressing the replacement behaviors. Remember that Molly's replacement behaviors include how to ask for a break, or how to leave circle time, and how to ask someone to leave her alone or not touch her. These match the function of escape and avoidance.

Let's look at Molly's intervention plan for replacement behaviors in depth. In the area of learning style, the team will use music and hands-on activities from her strengths and interests area. Since Molly's challenged by less structured schedules, her time will be highly scheduled, using consistent daily routines, times, visual schedules for the day and for individual activities.

The team will also use visual supports to help her understand directions, and to model the use of pictures to communicate. And to teach Molly how to use a break card to leave circle, the team will prompt her when it appears she's losing focus or getting frustrated. For environmental modifications, again, the team is including use of visual supports, also making sure Molly has plenty of personal space to support what was identified in her challenges area under sensory.

The team will also pair her with two student she's more comfortable with, rather than Shelly, who's physically friendly and identified as an antecedent to her targeted behavior. But team's also going to have other students moved to circle before Molly, so she could become aware a change is coming. In the sensory intervention area, the team's making sure Molly has lots of space in the routine of circle time. There will be more music, she'll have her own seat with a trial of a rocking chair and a cube chair. She may need to sit at the end of the table near peers who don't increase her sensory needs.

For social and communication interventions, the team is going to introduce a social script, and the break card to teach Molly how to ask to leave circle. They're going to use musical activities with peers to pair her interest in music with the challenging activity of being close to her friends. And they will use a social narrative with a lot of photos to show what she can do during circle time to interact.

The intervention plan area of reinforcement will include music during circle time, some choices on her schedule, hands-on learning activities added to circle time, and making sure Molly gets to leave circle time as soon as she requests a break with a card or a switch. Data will measure the frequency per week and how long she stays each day. The paraprofessional will count and time the events, and the teacher will graph the data.

Keep in mind that these things are the interventions being put in place just for the replacement behaviors. The team will need to introduce one or two interventions at a time, after prioritizing what they think will be the most helpful for Molly.

Now we will review the intervention plan for the related skills that Molly needs to learn. Remember the team decided Molly needed to improve academic skills for circle time so that she is less likely to want to escape or leave the group. In the intervention area, the team chose individualized instruction using ABA methods to teach math skills that are used in circle time. For learning style, the team will use manipulatives and limit verbal directions. As success is reached in one-to-one, the exact activity will be moved to circle time. As much as possible, the team will use objects she likes and enjoys.

Environmental modification interventions will include lots of personal space, and a consistent routine in circle time. There'll be music included and Molly will have her own seat in circle. The team will trial a rocking chair, a cube chair, and sitting at the end of the table with favored peers to see what works best for Molly. The team will be sure Molly gets a quiet, sensory break just before the academic activities in circle time.

For social and communication, Molly will be prompted to use social scripts and the break card to leave when the academics are frustrating her to a point of upset. The Related Skills Reinforcement Plan will be to use objects she enjoys when teaching the math concepts, making sure she can hold the objects in circle once she answers the math question, music, and hands-on activities in circle time, and choices on her schedules. Molly's data will include tracking progress of concepts being taught in one-to-one sessions, as well as those generalized to the circle time.

You'll probably notice that there's some crossover and repetition of interventions within areas of the Related Skills Plan, as well as from the Replacement Intervention Plan. Identifying interventions for each of these areas on both sides of the plan can then help prioritize where to start with Molly. Also in your downloadable packet, is the Strategy Checklist. Once you've finished the Replacement Skills in the Related Skills Intervention Plans, go through this checklist to be sure you completed all the parts and looked at all of the information you had gathered in the process.

So to complete building your plan, you will use the guiding questions discussed in slide 17 to develop your Replacement and Related Behavior Intervention Plans. Then you'll check to see if you thought about everything, using the Strategy Checklist discussed in slide 21.

Because many districts and agencies have approved behavior paperwork, you may want to transfer the information you've developed to the behavior plan forms required in your district or agency. Or in the state of Ohio, there is an optional behavior intervention platform that can be used.

We've included this Behavior Plan Steps Chart that takes you through each step of the plan, and shows what form to use-- visual support for you. Also there are two optional forms that may be helpful to some teams. The first is an Action Steps Form. If you've decided on an intervention or strategy that's going to require some planning and timelines, this form can help your team stay on track. The second is to review and check, and see if you have included strategies that change setting events, decrease stressors, and teach substitute or related skills.

To continue applying what you've learned in this series, you want to put in as much information you and your team can think of to include in all of the forms. Because you can't work on everything you've discovered at the same time, select which strategies you want to work on first. Use SART, which you're going to learn about in the last webcast to assess and revise those first strategies. And then implement those strategies. Remember to keep data on the strategies and continue to update your plan.

This process can be applied to other challenging behaviors in the same way you've learned through this webcast series. In the downloadable file, there are other case studies showing how this process might work for Molly with the behavior at home, and how it might work for an older individual named Joe. To complete the process, fill in a Reinforcement Chart for your individual. Then identify the interventions for each of the areas in Section Six for the Replacement Skills and the Related Skills Intervention Plans, and you'll be ready to start your interventions.

Thanks so much for learning with OCALI. Chris and I will see you for the final webcast, where you will learn about the Strategy Assessment and Revision Tool, or SART.

Discuss interventions and strategies and develop the positive behavior intervention plan for your student. The presenters will review reinforcement as a tool and in addition, take you through all the forms showing how they connect to development of a plan.

View all the Documents in this series here