Positive Strategies 2:
Developing the Behavior Intervention Plan
Tutorial presented at the 4 th International Conference on Positive Behavior Support March 8, 2007 Daniel Crimmins, Ph.D. Westchester Institute for Human Development & New York Medical College Anne Farrell, Ph.D. University of Connecticut Philip Smith, Ph.D. Westchester Institute for Human Development & New York Medical College
The Positive Strategies approach
Understand – by conducting a Functional Behavioral Assessment (FBA) Prevent – by identifying ways to minimize behavior as the first component of the Behavior Intervention Plan (BIP)
Replace – by teaching new skills or alternative behaviors as the second major component of the BIP 2
PHASE 1: CONDUCT THE FBA Develop student profile Assess behavior Analyze results
Develop hypothesis Test hypothesis 3
PHASE 2: IMPLEMENT THE BIP Brainstorm Prevent Manage 6 STEPS
Replace Monitor Maintain & extend 4
Working hypothesis ­ Nathan
Nathan’s problem behavior occurs… n when he has work with language demands n because when he does, he doesn’t have to do the work and peers laugh. This is more likely to happen… n when work requires complex written or verbal expression n and because he lacks frustration tolerance (self­ regulation).
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What is the BIP?
Shift from understanding to action n Part prevention, part management, part teaching n Requires n Completed FBA q Team… q n n Composition: High value on diversity, constituency Interactions and roles: Communication, accountability, anticipate difficulties, accommodations, course corrections
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The BIP process
n n Restate hypothesis ­ understand How can we prevent the problem behavior? q q q q n How can we replace the problem behavior? q q n Consider slow and fast triggers Short term strategies & longer term accommodations Links among strategies and triggers Interim behavior management Behavior alternatives Functional equivalence Outcomes q q q A working draft of the BIP expressed in steps A real plan to promote and monitor change Maintain and extend change across person, time, place
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Brainstorming
n n What is it? Roles and structure q q q q n Time­limited session, then discussion & planning Broad representation & leadership Facilitator, scribe Quick & lively Guidelines q q q q q All ideas are worthy of consideration. Criticism is discouraged. Develop team members’ ideas. Focus on divergence and novelty. Integrate student perspective.
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Prevention
n n n Renders the behavior unnecessary Functionally equivalent Based on hypothesis q q q n n n Focus on slow and fast triggers Prevent encounter with antecedents (modify or eliminate) Intervene before the behavior occurs Short­term focus Not contingent on the student’s response Action is taken by team, not student
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Prevention in context
n n Reduction in the frequency or intensity of problem behavior Why? q q q q q n Interrupt cycle: context à problem behavior à responses If behavior doesn’t occur, can’t be reinforced Establish a more positive environment, provide relief Meet legitimate student needs Protect and support integrity of learning community Prevention in relation to FBA and BIP q q q q Function of behavior Non­contingent – prevention is “free” Prevention ­ main focus on setting events and antecedents Prevention single component in larger BIP
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Prevention ­ considerations
n n Derived from understanding (FBA) Slow triggers / setting events q Monitor, alter, address typical setting events n n n n n Physical Learning and self regulation Social­emotional Environment and routines Fast triggers / antecedents q Focus on immediate precursors to behavior
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Prevention strategies ­ examples
Add structure to routine n Adjust medication, sleep n Reduce demands in difficult subjects n Provide alternate locations to complete assignments n Support or accommodate during difficult work n Provide opportunity for sensory input
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Questions about prevention
n Is this “giving in”? q q n What does student gain via prevention? Team? What is lost? Does prevention… q Reinforce the problem behavior? n q Affect learning of new behavior? n n q May provide greater opportunity May reduce extinction burst Give a larger “message” to learning community? n n n No, prevention is “free”, not contingent on problem behavior. We’ll let you get away with it. We will help you if you act up. What about teaching the student a better way? q Does not preclude alternatives ­ one part of larger plan.
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Results of Step 1 ­ Nathan
Brainstorming activity ­ Prevention
n Based on the hypothesis… What would stop this behavior from occurring? q Focus on function q n Now, 5 minutes of brainstorming Review working hypothesis q Suggest at least two prevention strategies q Provide at least two suggestions to others q Consider immediate and longer term
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Brainstorming ­ prevention
BIP Step 2 A – Short­term Prevention
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Step 2 B: Long­term Accommodations
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BIP Step 3: Manage
n Need plan to manage continuing incidents q q n Management v. crisis intervention Can behavior be adequately contained…? Interim behavior management q q q q q q Problems may persist despite prevention Forecast and foresee Identify triggers and early signs of problem behavior Typical v. desired consequences Consistent implementation is key Communicate with student
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Nathan’s Step 3: Manage
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Reconfiguring contingencies
Manage Problem Behavior Maintaining Consequences X Setting Events New consequences
Antecedents Preferred Behavior (Alternative) Natural Consequences Prevent Replace 21
BIP Step 4: Replace
n Replacement relates to prevention q q n What did prevention accomplish? Now, can student do instead? Effective replacement behavior q q q q q q q q Student is capable of learning and executing Reflects hypothesis Serves same function as the problem behavior Works as well as (or better than) problem behavior Natural Socially acceptable/valued Enhances functional skills Enhances quality of life!
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Replacement behaviors and function
Function Communicative Alternative Attention n Tangible n Escape n Sensory n Request, obtain social interaction, attention or praise Request for preferred items, activities or people Requests for assistance, breaks or changes in activity Request items that provide sensory stimulation or privacy
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Replacement behaviors ­ type
n Functional communication q q q n Self regulation q q n Observe self; modify behavior based on feedback Regulate attention, impulse; self calm Social skills q q n Language content and pragmatics (request, signal, etc.) Regulate behavior of self and others Social functions Manage social interactions with peers and adults Participation and transitions Academic skills q q Specific learning strategies Content as appropriate to age, grade, skills
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Brainstorming ­ replacement
n Based on the hypothesis and prevention: q q n Replacement q q q q q n What does the student need to do instead of the behavior? Brainstorming ­ don’t throw away ideas! What alternatives could replace problem behavior? What adaptive coping skills might reduce effects of slow and fast triggers? Function is key Consideration of current skill set is secondary Short and long term Generate at least two replacement behaviors for your own BIP and those of other members of your group (so that each person ends with three or more).
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Brainstorming results
n Replacement Behaviors generated q q n What does the student need to do instead of the behavior? Brainstorming ­ did you throw away ideas? Next, consider feasibility…
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Replacement: What is feasible?
n Need to know… Current functional skills (“does do” not “can do”) q Can student observe self? q Readiness of rule acquisition q Capable of enacting the RB? q Practice with feedback ­ overlearning? q n Prompts on Positive Strategies form, Step 4 Skill area q Current skill level q Support needed q Long term goal and benefits
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Teaching replacement behaviors
Assess, teach, coach self observation and/or develop tracking system n Functional relationships ­ contingencies n Rules and pivotal skills first n Stepwise (task analysis, shaping, chaining) n Motivational system v. natural reinforcement n Practice, practice, practice n Combine teaching and accommodations
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Teaching replacement behaviors
n n n Relate function of problem behavior to desired RB Assess skills deficits Expertise of team members, IEP team, PBS coach, other PBS and school resources q Who can shape BIP to develop skills in: n n n n q n n Functional communication Self regulation Social skills Academic skills Consult external resources/experts as needed Entire PBS, CBT, ABA literatures as resources Resources and examples in handouts
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BIP Step 5: Monitor
n First set goals q q n Based on FBA steps, what is success? At what point do we rethink plan? Monitoring q q Adherence to plan ­ fidelity Problem behavior n n q Baseline Ongoing occurrence Replacement behaviors n n n Baseline Ongoing occurrence Anticipate relationship between problem and replacement?
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Monitoring progress
n Team communication n n n n Frequency and format Responsibility and accountability Liaisons across home and school Assessment ­ intervention link q The BIP needs retooling when… n n Not adhered to ­ why? Not working… q q q n Hypothesis correct? Efforts matched to student? BIP potent enough (“dosage”)? Working really well! q What’s next…
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Steps 4 & 5
n BIP Steps for your student Step 4: Replace q Step 5: Monitor and evaluate q n Thinking ahead… Step 6 q How might change be maintained and extended q Generalization is key.
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BIP Step 6: Maintain and extend
Train and hope is not enough n Promote maintenance & generalization n Use natural reinforcers q Eradicate competing reinforcers q Train loosely q Vary context: settings, conditions, peers, teachers q Incorporate self monitoring, self instruction q Foresee risky situations, lapses q Booster sessions q n It’s about quality of life
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Closing thoughts
n The Positive Strategies framework q q q n BIP derives from FBA q q q q n Understand…Prevent…Replace Team approach Student­centered, proactive, antecedent based Capitalizes on understanding of function Requires assessment of current skills Ongoing and flexible No real limits on resources Problem behavior as opportunity q q Emerge from legitimate needs Chance to collaborate in service of… n n Improved quality of life for students Enriched learning community for all
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End notes
§ Materials were excerpted from our new book (with Alison Bailey): Positive Strategies for Students with Behavior Problems from Paul H. Brookes Publishers (http://www.brookespublishing.com/store/books/crimmins­ 68783/index.htm or 800.638.3775) § Thanks to the Administration on Developmental Disabilities and the New York State Developmental Disabilities Planning Council for their support. § Correspondence should be sent to: § [email protected] § WIHD/Cedarwood Hall Valhalla, NY 10595
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