Addressing Challenging Behavior - Part 4

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Are you ready for webcast four? Hi there. Wendy back with you today. Just a reminder, in order to build your knowledge step-by-step you need to have completed webcasts one through three before beginning webcast four. Today we're going to be discussing setting events and triggers.

Since the last webcast, you looked at a number of key areas that could contain challenges that underlie and drive the behavior the person is experiencing. These areas include learning challenges, environmental mismatch, sensory and biological factors, social, emotional and communication challenges, and issues surrounding motivation. Remember, there's a lot of information in this webcast, so please hit the Pause button or back up a bit and listen again if you don't get this the first time. It's OK to take your time as you gain this knowledge.

In this section, we're going to break down the area of the antecedents to help understand what is occurring and where interventions need to target. When attempting to understand challenging behaviors of individuals with more complex needs, it's often necessary to look even more closely at factors surrounding behavior. Important information may be very deep below the surface. Much like the bottom of that iceberg that we compared behaviors to in previous webcasts. Previously, we discussed antecedents, and describe them as those things occurring before a behavior, and having an influence on the behavior. Today, we're going to break that down even further and describe antecedents as either setting events or triggers. Identifying setting events, triggers, and reinforcement allows you to discover the reasons why a behavior developed. We will also be looking at consequences and reinforcement. So let's dig in.

Setting events are those things that happen before a behavior and make the behavior more likely to occur, but are not directly related to the behavior. Setting events influence how the individual is approaching the day. Many times you may feel in our gut that the individual is out of sorts. It's a feeling that something just isn't quite right with that person, but we aren't sure what that might be. I've had teachers say, "I saw Josh getting off the bus and knew something wasn't quite right." When we get to know the person's we support, we learn to recognize when a setting event might have occurred. As we said earlier, setting events do not directly cause the behavior to occur, but they do make it more likely to happen, and can be very important to identify and address.

For instance, maybe dad's alarm didn't go off this morning and so everyone is running around a little late and rushing around to get breakfast, get dressed, and out the door on time. This affects Davy by making him anxious and little fussy as he goes through his rushed home routine. However, when Davy gets to school and as he approaches journal time, which is a challenging task for him, he throws a journal and pen across the room while yelling he's not doing journal today.

Teachers and peers are surprised, because although Davy never really liked journal time, he's never reacted that strongly before. Being late in this scenario is identified as a setting event to throwing his book and yelling. If Davy had not been agitated from being late and rushed, the behavior might not have occurred or might have been less intense. Here's a list that includes items that have frequently been reported as setting events to behaviors. Do they look familiar? And I bet they do. Hunger, thirst, sensory biological challenges, and changes in routines can all make a person's mood more fragile and more vulnerable to the triggers encounter.

How can we support the individual when one of the setting events takes place? One way is to share information between home and school in a nonjudgmental fashion. Sometimes, families schedules do not run smoothly. Sometimes teachers are unexpectedly absent. These are the realities of life. School personnel, employers, caregivers, and families need to have a reliable, trusting and respectful communication system to share this information. If the support staff or family knows a setting event has occurred then interventions can be implemented and hopefully challenging behaviors can be avoided or made less intense.

The same goes for school staff, or employers, sharing setting events that occur on their time to the family, so home time can be adjusted for the individual. Does this is make sense to you? Do you feel like you understand setting events? If not yet, hit rewind and listen again. If yes, let's forge on ahead.

Let's talk about triggers. These are things that happen close to the occurrence of the behavior and have a direct impact to the behavior. We're going to talk about possible trigger categories to consider. One category that might be a trigger could be a person in the immediate environment. The person who is a trigger may have absolutely no intention, or be purposefully meaning to upset the individual, but something about the way they move or sound or behave or interact or some other aspect of the person inadvertently can set off the individual.

One family shared their experience with this factor. They determined that the brother's voice was very irritating to the sister with special needs. She would go to a different floor of the house than her brother, until his voice changed when he became a teenager. After that they could be together.

Determining that a trigger is a person in the environment allows the behavior team to address the issue through the behavior plan. Another category for possible triggers is an activity or demand. Certain activities or tasks may be less desirable, frustrating, confusing, or too hard. Possibly transitioning from one activity to another is a challenge, or the way an individual's asked to do something can also be a trigger. Identifying activities are demands that are triggers gives the behavior team an entry point to consider for intervention.

We also want to consider environment or sensory challenges as possible triggers. Individuals may have sensitivity to sounds, sites, touch, or certain things in the environment might bring on the fight, flight, or freeze response. If these are possible triggers, interventions can be developed to address those needs. There also might be emotional triggers. Certain situations may bring on fear or anxiety that can lead to observable behaviors that are not appropriate. Over time with repetition these instances can lead to the same reactions as trauma can invoke.

Again, recognition of these possible triggers allow supports to be put in place for the individual. Being aware of an individual's triggers allows you to be prepared with support interventions, and also helps identify what new skills and coping systems need to be taught so the person can start learning how to regulate his or her reactions, and sometimes yes, setting events and triggers can look similar. Understanding how these events fit into the escalation of behavior for the specific person in the particular situation allows one to determine just what role the events play in the targeted scenario.

Do you have triggers down now? I hope so.

In the packet you downloaded, there's a guidance form that lists these questions to help think about potential antecedents. These will help the behavior team looked deeply at what is happening before the behavior to better understand why the behavior developed. Let's move on and look at Molly's ABC, with the addition of Setting Events and Triggers.

We see that Molly setting events include Mondays, which may be due to the change of routine. Another setting event is when Molly is not able to finish what she's doing and is rushed to the next activity. These events do not directly cause the screaming, but they make Molly more anxious and less able to tolerate what's coming next. Her triggers appear to be entering circle time, being touched, and a specific classmate name Shelly, who is really friendly, but overwhelming to Molly. When these triggers happen it's very likely Molly will exhibit the target behavior.

If you're working on this process with an individual, here are your next steps. Fill in the Setting Events and Triggers on this form using the guidance document for identifying antecedents and the information in this webcast. Once you work through these steps, you'll be ready for webcast five. Chris will see you there.

Learn to break down antecedents and identify them as setting events or triggers. Examining what happens before a targeted behavior helps you to discover the reasons why a behavior developed and enables you to better match your intervention to the child's needs.

View all the Documents in this series here