Challenging Behavior


AT Considerations for ASD Wikispace link:
http://atconsiderations-asd.wikispaces.com/Behavior

Understanding Problem Behavior:
  • Before a student's behavior can be changed, we first have to understanding why it is happening. This is called the behavior's "function." The form of the behavior (what it looks like) is not as important as it's function (underlying motivation behind the behavior, which doesn't require awareness by the student). This requires an examination of the environmental variables that are contributing to it, and making the necessary changes to prevent or respond to the behavior in the future.
  • Both appropriate and inappropriate behaviors serve a purpose for the student, communicating something to those around him/her.
  • Many problem behaviors are learned based on past experiences with the environment
  • 2 primary functions of behavior:
    • To obtain something: Attention or tangible items/activities; obtain sensory input
    • To escape or avoid something: Non-compliance falls under this function; avoid sensory input; pain reduction

Analyzing Student Behavior:
ABC_image.pngABC_Example.png

Behavior alert: Consider whether behavior problems associated with academics or functional skills are the result of a skill deficit or a motivational deficit:
  • Skill deficit: the student does not understand the instruction given, or how to complete the request you give him/her. Visual representations of these combined with verbal instructions can be very helpful.
  • Motivational deficit: the student understands the instruction or knows how to complete the request you give him/her (e.g., how to line up for lunch). If the student has completed the request previously with success (independently), this is the likely source of the behavior problem. Utilizing visual supports may be less effective here, because the source of the behavior problem is to avoid or escape the activity itself. The icon serves as a reminder of what he/she wants to avoid.

Essential Intervention Components
1. Clearly defined behaviors
  • To decrease (inappropriate ones)
  • To increase (appropriate alternatives; teach new skills)
2. If there is a skill deficit (vs. motivational), teach the skill
3. Antecedent strategies (preventing problem behavior)
  • What to include in the environment (classroom, hallway, etc.)
  • What not to include in the environment
4. Consequence Strategies (responding to problem behavior)
  • How staff should respond when appropriate behavior occurs
  • How staff should respond when inappropriate behavior occurs

Behavior Intervention Plan (BIP)
Some students will have a BIP that provides specific interventions to increase appropriate and decrease inappropriate behaviors. This is not the same as IEP goals/objectives that specify specific behavior change that is to be measured. The BIP is the "roadmap" that explains what strategies are in place to reduce problem behavior as well as increase appropriate replacement behaviors. For example, a replacement for the yelling out answers is raising his/her hand. Both behaviors serve the same purpose, but hand raising is the appropriate response. Replacement/alternative behaviors of the student are reinforced by others, and should increase over time, while inappropriate behaviors are no longer reinforced, and should decrease over time.


Least Restrictive Behavioral Interventions (LRBI) Guidelines
Developed by the Utah State Office of Education

Preventing Problem Behavior (Antecedent Strategies)

Overall, the goal is to prevent problem behaviors from occurring in the first place. Once we know why a behavior occurs (its "function"), we can determine if AT tools and strategies can be implemented to lower the likelihood of it happening in the future. These antecedent strategies are designed to modify the environment before problem behaviors occur. Reducing problem behavior is only one part of the equation. Determining methods for increasing appropriate behavior are essential, because those behaviors will replace the inappropriate ones. Why? Because they will serve the same purpose for the student. For example, selecting a "break" card during a difficult tasks is an appropriate replacement behavior for destroying work materials.

One important component of reducing problem behavior is identifying replacement/alternative behaviors. These behaviors are intended to take the place of challenging behaviors because:
  • They serve the same "function" as the problem behavior
  • They are reinforced
  • The inappropriate behaviors are no longer reinforced, encouraging the student to engage in the alternative behavior instead.

Replacement behaviors must be:
  • Functionally equivalent (they serve the same function). For example, using PECS to request bathroom would replace the student running out of the classroom to the bathroom
  • Socially appropriate
  • Suitable for the student's skill level: He/she must be able to use the replacement behavior with as little effort as possible. The more difficult it is to do, the less likely the student will be to use it, especially if the problem behavior has been effective in the past.
  • Incompatible with the problem behavior: It is difficult to engage in both inappropriate and appropriate alternative behaviors at the same time.
  • Planned in advance and taught

General Strategies:
  • Have a comprehensive reinforcement system in place to encourage appropriate behaviors [SEE REINFORCEMENT LINK
  • Rules and routines: http://www.txautism.net/docs/Guide/Interventions/Rules.pdf
    • Having rules and routines in place provides structure and a more predictable environment for the student. Post classroom rules, refer to them regularly, and be consistent with them. For rules specific to a particular student, make those easily accessible
    • Rules help the student to understand what behaviors are expected. They can be developed for an entire classroom, or individualized for students. Rules may vary by location, so consider which rules are most relevant for the student in each. For example, a rule for "staying in my chair" would not be applicable in P.E.
    • Routines, such as daily schedules, allow for more efficiency and independence by the student. See VISUAL STRATEGIES for more information on scheduling
    • Rules and routines must be directly taught. Pre-teach using role-playing or social narratives, and follow-up instances of rule-breaking by reviewing the rule(s) and what consequences are in place when the student does or does not follow the rule(s) in the future. Focus on positive outcomes for rule-following.
  • Reinforce the absence of the problem behavior.
    • In this intervention, there is no alternative/replacement behavior to reinforce, so you are reinforcing only the absence of the problem behavior. Pair verbal praise with any other reinforcement provided ("Thank you for not talking during the play") Examples:
      • Sitting quietly in an assembly
      • Not yelling out answers in class
      • Not singing or making noises during class
  • Prepare the student for upcoming changes that are part of the daily schedule (e.g, almost time to line up for lunch)
  • Prepare the student for changes to schedules or daily routines (e.g., telling the student that he is leaving early that day)
  • Adjust the student's seating location to account for:
    • Proximity to the teacher. Seating the student closer to the teacher allows for more ease of reinforcement, prompting, and social interactions, and addressing problem behavior.
    • Accessibility to a paraprofessional, if one assists the student in the classroom. Avoid seating the student in a location that will be distracting to other students, or draw unwanted attention to the paraprofessional assisting the student.
    • Peers: avoid seating the student next to peers who display inappropriate behaviors or respond to the student's behaviors. Instead, find peers who model appropriate behaviors for the student (i.e., completing academics, staying seated, appropriate vocalizations, raising hand to ask questions, etc.)

Attention function:
  • Give attention throughout the day for "free." This type of attention is not directly related to a particular behavior the student is displaying. The goals is to lessen the student's motivation to gain attention, especially in inappropriate ways, because it is already being given freely throughout the day.
  • Reinforce appropriate attention-seeking behavior. It is important to determine ahead of time which behaviors to reinforce, and how frequently.
  • Prepare other students to respond appropriately to student behaviors. For example, a student's peers ignore his burping, which has an attention-seeking function.

Tangible function:
  • Give access to preferred items/activities throughout the day, unrelated to a particular behavior the student is displaying. Having regular access lessens the motivation for it, which reduces the need for problem behaviors to obtain or avoid leaving it. Caution: This may lessen the effect of the item/activity as a reinforcer, because the student has access to it at other times of day. Consider using different reinforcers for each.
  • Give sufficient warning when an activity is about to end (i.e., computer):
    • Preparing the student in advance may lessen the significance of having to stop an activity, because it is expected and the student can prepare for it.
    • Use visual supports to communicate the ending of the activity:
      • Referring to timers or clocks
      • Number of minutes left written on note card, or hold up fingers the represent the minutes left
      • Using a "green-red-yellow" visual: Green = activity is ongoing; Yellow = activity is about to end; Red = activity is over
      • Use a "finished" icon to symbolize the ending of the activity
  • Avoid placing demands that involve both stopping a preferred activity, and being asked to do something that is non-preferred by the student. Example: asking the student to put a toy away and come sit down to complete a math worksheet. Instead, place a neutral, high-probability demand that will require the student to leave the activity ("Go give you lunch box to Ms. Grayson"). Reinforce compliance to this, then present the non-preferred demand. This is known as behavioral momentum.
  • Transitions:
    http://atconsiderations-asd.wikispaces.com/Transitions
    • Changes in daily routines: It is important to prepare the student on days that changes to routines will occur. This should be done as early as possible, even days ahead of time. At the minimum, give notification just before the change occurs. Use an icon to represent the change, such as a photograph of an assembly in the cafeteria (take pictures of this assembly to use for future incidents). If possible, incorporate this icon into the daily schedule, and review it multiple times. Discuss and gesture to where the change will occur, and check for understanding.
    • Warnings: utilize visuals, such as a clock or timer (with sound or visual only - time timer). Can also use visual countdown by having numbers that are crossed off as time approaches
    • Use "forewarning cards," which give a visual representation of what will happen next (e.g., picture of activity)
    • Color-code transitions: green card = activity is available; yellow card = 1 minute left; red card = time to stop (pair verbal messages with these)
  • Teach tolerance of transitions away from preferred activities through regular practice:
    • Throughout the day, place simple demands while the student is with the object/activity. These should require him/her to temporarily stop to comply (i.e., throw something away, sit in a different location).
    • Practice giving warnings and transitioning directly from the activity to non-preferred activities. This increases the likelihood of problem behaviors during the rehearsals, but it also increases the frequency of compliance when the scenario occurs in "real life." This can be done throughout the day or during a pre-scheduled period of time in the student's daily schedule.
  • Reward tolerance for transitioning without problem behavior: If a student with a history of problems transitioning leaves a preferred activity without problem behaviors, consider reinforcing him/her by:
    • Immediately allowing additional time with the activity
    • Giving points/tokens towards the next time reinforcement is provided

Escape / Avoidance function:
  • Reinforce compliance. Staff need to determine the frequency of reinforcement for this, which is based on:
    1. After a certain number of tasks are completed
    2. After a certain amount of time has passed
  • Utilize accommodations and modifications specified in the student's IEP. Making academic content more accessible to the student at a level appropriate for him/her will reduce its aversiveness as well as challenging behaviors the student utilizes to avoid or escape it.
  • In general, avoid asking the student to do something that you are unable to follow-through on were he/she exhibit non-compliance. For example, giving the student a difficult task 5 minutes before the class leaves for lunch.
  • Use prompting to reduce errors, resulting in more successful responding and access to reinforcement. [SEE ACADEMICS-TASKS LINK]
  • Use Task Analysis to break complex activities (e.g., playing a board game) or sequences of behaviors (e.g., morning routines) into smaller steps, each of which can be taught individually. It also provides a clearer indication of which steps in the sequence the student is having difficulty with [SEE ACADEMICS-TASKS LINK]
  • Allow for flexibility in seating and movement during academic activities. It may be acceptable to allow the student to stand at his desk from time to time if assignments are being completed. If the student's current seating location is interfering with task completion (too loud, etc.), allow the student to move a different seating location.
  • Allow the student access to a preferred item (age-appropriate) if he/she finishes early and others are still working. For example, allowing a student to read a book when she finishes an assignment will increase motivation to begin and complete the assignment, and will reduce the likelihood of inappropriate behaviors that could occur if there is extensive "down time" after the assignment.
  • Allow choice: http://www.txautism.net/docs/Guide/Interventions/ChoiceMaking.pdf(Texas Guide for Effective Teaching - TARGET)
    • Providing opportunities for choice-making has shown to be successful in managing problem behaviors
    • Choice: between a selection of activities, the location where non-preferred tasks are completed, the order tasks are completed, who activities are completed with
    • Methods students can use make choices: verbally, pointing to objects/pictures/sketches, handing an image/sketch to someone, VOD
    • Make the behavior of choice-making as effortless for the student as possible
    • Implementing choice-making
      1. Determine if the student can currently make the association between a choice and the consequence of that choice (e.g., receiving the item depicted in a PECs icon). Teach the prerequisite skill of choice-making if necessary but "pairing" the choice made by the student and the outcome of that choice (e.g., student reaches for toy, teacher gestures for student to select the icon of the toy, teacher provides the toy to the student)
      2. Determine the response form the student will use to make choices (e.g., verbal, PECs)
      3. Determine what choice(s) will be provided to the student, such as items and activities. Consider using choice initially in circumstances where problem behavior occurs consistently, as this may reduce the likelihood of the problem behavior.
      4. Implement choice-making and monitor student progress. If problem behavior is not reduced as a result, it may be that the relative "value" of the behavior is more powerful than the choices the student has to select from. In this case, additional interventions may need to be included, such as a reinforcement system.
  • First-Then: Use a "First-Then" strategy, which visually displays the activity/activities to be completed as well as what the outcome/result will be (usually access to a reinforcing item or activity).

First-Then_Folder.png


  • Behavioral momentum: In this strategy, high-probability requests that the student is more likely to follow (easier, simpler, more familiar) are given first, which results in successful responding that can be reinforced. Immediately following these behaviors, the student is given a request(s) that are more likely to result in non-compliance. The momentum created from the student already complying to other requests increases the likelihood that he/she will comply to additional requests, even if they are more difficult/aversive. Example:
    1. High-probability: "Go put your library book in your backpack"...reinforce "Please put your lunchbox in the cabinet"...reinforce
    2. Low-probability: "Please finish the last 5 problems of your homework"...reinforce
  • Teach appropriate ways to escape or avoid non-preferred activities, such as academics (see Break Cards and Skip Cards)
  • Break cards: Student allowed to take a temporary break from an activity, but must finish it when the designated time has passed (3-5 minutes usually) [See COMMUNICATION page for more specifics]
  • Skip cards: Student allowed to skip an activity Note: provide a limited number of these daily, then reduce over time as student is more successful. The process of selecting the cards will have to be taught. It can involve gesturing to an icon on the student's desk, or giving an actual card to the teacher. [See COMMUNICATION page for more specifics]
  • State what you want the student to do, not what you do not want him/her to do: For example, saying "Walk please" instead of "Stop running."

Individual Student Rules
Rules and Routines - Texas Guide for Effective Treatment (TARGET): http://www.txautism.net/docs/Guide/Interventions/Rules.pdf
Keychain Rules: This portable strategy allows the student to have access to the rules developed for him/her throughout the day. They can be referred to by the student as needed, or reviewed by adults when rules are or aren not followed.
Keychain_rules.png

Use special interests of the student - Texas Guide for Effective Teaching (TARGET): http://www.txautism.net/docs/Guide/Interventions/UsingSpecialInterests.pdf

Responding to Problem Behavior (Consequence Strategies):

These are implemented once problem behavior has occurred.

General Strategies:
  • It is important to reinforce appropriate behaviors when they occur (positive consequences). Use specific verbal praise frequently
  • Staff should agree on how to respond when inappropriate behaviors occur. This response should occur as soon after the behavior happens as possible. Extended delays can weaken the connection between the unwanted behavior and consequence.
  • Consistency is essential for behavior change. Implement the behavior intervention(s) every time it's needed, and use data to determine if it is effectively changing the behavior.
  • Interventions should be designed based on the behavior's function
  • Avoid providing reinforcement for the behavior, regardless of its function. Be prepared for an "extinction burst," which is a temporary increase in the frequency and intensify of the behavior. This is seen because the environment has been changed is not responding as it typically does (e.g., not allowing avoidance of task demands). This is typically short-lived when the behavior intervention(s) are implemented consistently, because the problem behavior is never reinforced and thus does not "work" for the student. Additionally, appropriate alternative behaviors are being reinforced, making them much more likely to occur over time in place of the problem behavior.
  • Make sure you are practicing (and reinforcing) the alternative behavior throughout the day. This may require you to create scenarios in the classroom or around the school that allow for practice, reinforcement, and correction to occur.
  • If using negative consequences:
    • They should only be delivered contingent on the occurrence of the problem behavior
    • The consequences should be mild
    • Negative consequences should be applied in conjunction with positive consequences. That is, if negative consequences are applied, you should be ready to apply positive consequences at the earliest opportunity.
    • the ratio of positive to negative comments should be at least 4-to-1.
    • Maintain the student's dignity when delivering negative consequences
    • Use a neutral tone of voice at a normal volume. Avoid emotional reactions

Attention function:
  • If the function is to obtain attention, even giving negative attention (e.g., reprimands) may reinforce the behavior instead of reduce it.
  • It may be preferable to ignore minor behaviors, especially if they are for attention. By not providing attention for these behaviors, they should happen less often over time. Combine this with prompting and reinforcing alternative behaviors as frequently as possible to shift the student towards displaying those behaviors instead in the future (they work, but the problem behavior no longer does). This is called "planned ignoring."
  • If the behavior is mild (e.g., whining), attempt to prompt the alternative response ("Help me please"). Caution: Because you are actually reinforcing the inappropriate behavior, you may see an increase in it. The purpose is to replace a behavior with the one you are prompting, so have a plan for fading your prompt and teaching more acceptable alternative.
  • When the function is for attention, use visual supports as prompts instead of social attention. Example: hold up "quiet" or "stop" sign when student is talking loudly.

Tangible function:
  • Use visuals to communicate that the activity is no longer available, such as:
    • stop sign or other icon that symbolizes that the activity is finished
    • a timer that is beeping or showing no more time left
    • An icon on the daily or activity schedule that displays what the student is to be doing next
  • If other peers were engaging in similar tasks, bring attention to the fact that they have stopped
  • Give the student a small request to complete that is preferred by the student, such as helping another student or taking an item to another teacher across the room. This behavior can be reinforced, while at the same time it pulls the student's attention from the tangible he/she was not wanting to stop. Additionally, it allows you to focus your comments on him/her complying to your request, instead of discussing the loss.
  • Prevent continued access to the item or activity (e.g., put toy away, turn off computer screen). Allowing the student to have extended time with the activity after problem behavior actually reinforces it, making it more likely the student will display the same behavior again in the future.
  • Once the tangible is stopped or removed, prepare for additional behaviors, which may range from verbal protests and trying to get the item from you, to property destruction or aggression. This is similar to the extinction burst discussed in the General Suggestions section above.

Escape / Avoidance function:
  • If the behavior is mild, prompt the alternative response (e.g., student tapping pen loudly, teacher prompts student to ask for help). This is most helpful when there is a skill deficit for the alternative behavior, meaning the student does not know how to do the appropriate behavior (e.g., ask for help).
  • AT strategies and tools:
    • Picture of the student completing an assignment at desk
    • Pointing to classroom rule that is being violated (e.g., "finish all my work")
    • Skip / Break cards [SEE ACADEMICS - TASKS SECTION]
    • Pointing to a picture of the reinforcer the student has selected to receive for appropriate behaviors
    • If a token system is in place, bring attention to the points earned so far.
  • If the problem behavior persists, use escape-extinction, which involves not allowing the student to avoid or escape your request. This may take a more lengthy period of time, especially early on in its usage. For this reason, "pick your battles," and only give requests you are willing to follow through on.

Automatic function:
  • Note: Ignoring behaviors that are self-reinforcing will not reduce them.
  • For vocalizations:
    • prompt an alternative, more acceptable vocalization (e.g., sounds/noises into singing a song)
    • in most cases, do not repeat the sounds/words back to the student
  • Consider environmental changes to lessen sensory input that may be discomforting (e.g., classroom noise).
  • Interrupt and redirect the student to engage in more appropriate behaviors. This may require blocking the student from engaging in the behavior (e.g., blocking hand mouthing)
  • Consider incompatible behaviors: these are behaviors that cannot occur at the same time as the inappropriate behavior.
  • Make a point to teach and reinforce more appropriate alternative behaviors.

Making behavior expectations visual:
  • Do not assume the student is aware of the variety of behaviors you want him/her to do or not do.
  • Prioritize the behaviors you want to see INCREASED, which are usually replacements for those you want to see decreased (e.g., raising hand replaces yelling out)
  • Make a visual representation of these behaviors (no more than 5 at a time).
    • Use photographs of the student engaging in these behaviors
    • Make a written list of the behaviors, each having a number
    • Same approach can be used for classroom rules
  • Location of visuals:
    • Permanent: taped to student's desk
    • Portable: note card, small clipboard
  • Using the system:
    • Acknowledge and reinforce the student regularly when they engage in the appropriate behaviors
    • When inappropriate behavior occurs, refer to the image/text that represents what they should be doing instead. For numbered behaviors/rules, you can eventually refer to the numbers alone. This draws less attention to the student in inclusive settings. For example, when a student is out of his seat the teacher asks, "What is rule #2?" (which corresponds to "stay in seat")

Incredible 5-Point Scale - Texas Autism Resource Guide for Effective Teaching (TARGET)
http://www.txautism.net/docs/Guide/Interventions/Incredible5.pdf
Incredible_5_point_scale.png

Monitoring Behavior Change
Data collection is an important complement to behavior interventions. It allows you to gather information on a student's behaviors before interventions are put in place, as well as how he/she is responding to the interventions. Three basic data collection tools to consider are
  1. : The number of times a behavior occurs, which can be done as a simple tally or based on the number of occurrences in a period of time. Use this approach when you want to increase or decrease the number of occurrences of a behavior, such as property destruction.
  2. : Allows you to monitor the length of time a behavior occurs. Use when the duration of a behavior is the focus, such as time out of seat or off-task behaviors.
  3. : This type of data collection provides useful information on what is occurring in the environment before and after problem behaviors occur. It allows for an examination of the potential triggers (antecedents) as well as which responses (consequences) may be contributing to the behavior. It provides useful information when developing interventions, because the "A" and "C" are where behavior interventions are implemented.


Developed by the IRIS Center