Behavior Support Planning

Behavior Support Planning Mapping an Individual Behavior Support Plan using the Pyramid Model Practices ECN Training Thursday April 4th, 2013 Melissa Binkley & Beth Vorhaus

[Assessment-based interventions result in individualized behavior support plans.] Treatment Prevention Universal Promotion The Pyramid Model Module 3

Behavior Is communicating… Skill to be developed Potential unmet need

A 6 month-old cries for long periods of time unless held by his caregiver… 1. What is the ‘tip of the iceberg’ behavior? 2. What social-emotional skill is needing support? 3. What might be going on for this child? (possible unmet needs)

Old Way versus New Way Old Way New Way Intervention matched to purpose of the behavior Intervention is proactive Focus on teaching new skills Long-term interventions • General intervention for all behavior challenges • Intervention is reactive • Focus on behavior reduction • Quick fix

Behavior Support Plan • Behavior Hypotheses- Purpose of the behavior; your best guess about why the behavior occurs • Prevention Strategies- Ways to make events and interactions that trigger challenging behavior easier for the child to manage • Replacement Skills– New skills to teach throughout the day to replace the challenging behavior • Responses- What adults will do when the challenging behavior occurs to ensure that the challenging behavior is not maintained and the new skill is learned

Behavior Hypothesis Expands on the behavior equation and incorporates what you have learned from the observations and interviews Includes information about: • Function of the behavior • Triggers of the challenging behavior • Description of the challenging behavior • Responses that maintain the challenging behavior HO: Hypothesis Statement

Data Collection Collecting data about a child and the challenging behavior helps us identify the form and understand the function. Information that is collected to determine the function of a behavior is called a “Functional Assessment” • Literally, the assessment of the behavior’s function

Conducting a Functional Assessment • Observe the child in target routines and settings • Look for situations that predict challenging behavior and situations that predict appropriate behavior. • Interview persons most familiar with the child • Parents, Grandparents, Teachers • Review records

Behavior Support Plan • Behavior Hypotheses- Purpose of the behavior, your best guess about why the behavior occurs • Prevention Strategies- Ways to make events and interactions that trigger challenging behavior easier for the child to manage • Replacement Skills– New skills to teach throughout the day to replace the challenging behavior • Responses- What adults will do when the challenging behavior occurs to ensure that the challenging behavior is not maintained and the new skill is learned

Look at the Function of the Behavior Ask yourself… • How can the environment be changed to reduce the likelihood that challenging behavior will occur? • What can be done to make challenging behavior irrelevant? • What procedures can I select that fit in the natural routines and structure of the classroom or family? • How can I build on what works? • What can be done to help the child not respond to the trigger or change the trigger so it does not cause challenging behavior?

Teaching Replacement Skills • Replacement Skills are alternative behavior to challenging behavior. • Replacement skills must be efficient and effective (i.e., work quickly for the child). • Make sure the reward for appropriate behavior is consistent.

Competing Behavior Equation Adult gives child another turn. Child yells, kicks, throws. Child told sibling gets a turn. Adult says “one more turn, then (siblings’s name)’s turn” and gives turn. Child asks for one more turn.

Functional Equivalence • Replacement skills should have functional equivalence • Identify an acceptable way that the child can deliver the same message. • Make sure that the new response is socially appropriate and will access the child’s desired outcome. • Teach the child a skill that honors that function of the behavior (e.g., if child wants out of activity, teach child to gesture “finished”).

Response to Challenging Behavior • Respond in a way that will make challenging behavior ineffective. • Make sure rewards for appropriate behavior are equal to or exceed rewards for challenging behavior.

Safety-Net Procedures • If a child is in danger of harming self or others, you must first be concerned about safety. • You may hold a child or remove a child from the situation to keep children safe. • Safety-net procedures may be planned for children who have a history of dangerous outbursts. • Safety-net procedures only keep children safe; they do not change behavior. • Safety-net procedures are appropriate only when there is also a full behavior support plan or intention to develop a plan.

Developing an Individual Support Plan • Identify the basic equation (trigger, behavior, maintaining consequence) of the challenging behavior. • Identify the function of the challenging behavior • Brainstorm Prevention Strategies • Brainstorm ideas about what Replacement Skills should be taught to replace challenging behavior • Brainstorm ideas about how to Respondto challenging behavior when it occurs. • Implement with Intentionality, then: Review, Edit, Tweak, Reapply…

Keep in Mind: Behavior Support Plans also… • Subscribe to Program Rules & Protocol • Outline clear steps in developing a plan to address the behavior • Identify role/participants on the team (Parents/Family, Teachers, Home Visitors, Assisting Teachers/Paraprofessionals, Therapists, Administrative Staff, Mental Health Consultant, Others…?) • Lay out how progress will be reviewed, how changes will be made in the plan • Stipulate how decisions will be made about ending or modifying the intervention protocol

Behavior Support Plan Development Step One • Identify the basic equation (trigger, behavior, maintaining consequence) of the challenging behavior. Handout 4 & 5

Behavior Support Plan DevelopmentStep Two • Identify the function of the challenging behavior.

Behavior Support Plan DevelopmentStep Three • Brainstorm Prevention Strategies • Strategies to make routines or activities easier for the child • Strategies to soften the triggers

Function:

Behavior Support Plan DevelopmentStep Four • Brainstorm ideas about what Replacement Skills should be taught to replace challenging behavior. • Think about what skills the child already has • Think about what skills can use scaffolding

Behavior Support Plan DevelopmentStep Five • Brainstorm ideas about how to Respond to challenging behavior when it occurs. • Consider current demands on teachers • Keep responses easy to use/remember

Function:

Behavior Support Plan DevelopmentStep Six Intentional Implementation - Immediate: • Review plan ideas; eliminate pieces that don’t fit or are too difficult for team to do. Emphasize that each column is necessary. • Create an Action Plan so that each team member knows what, when, and how the strategies will be implemented. Intentional Implementation - Ongoing: • Repeat process for other routines, settings, or behavior functions. • Consult with a mental health professional if the child is not responding and the intensity, frequency, and duration of the behavior is not improving.

Plan Development Tips: • Develop plan using plain language. • Develop action plan of who will produce what components needed to implement the plan. • Make sure plan will fit with routines, activities, and values of family and teaching staff. Design components that are easy to use, easy to remember. • Plan must accommodate competing demands on teaching staff and family. • Focus on ONE behavior at a time. Develop mini-plans for difficult routines.

Activity 3-4

Michael’s Challenging Behavior Case Study Example

Michael’s Challenging Behavior Example 1:

Michael’s Challenging BehaviorExample 2:

Michael’s Functional Assessment Interview Key Points: • Same pattern at home as at school • Child not sleeping through the night • Eats very quickly & takes food from others • Limited in choices he gets to make at home • Eating & Free Play are most frequent settings for challenging behavior • Set Offs: Mom talking on phone/attending to others • Engaging in behavior leads to pay-off, “almost every time” • Likes to: read w/adult, play alone with adult, play with cars & bouncy balls

Behavior Support Plan Development Step One • Identify the basic equation (trigger, behavior, maintaining consequence) of Michael’s challenging behavior. Trigger Group play: outside play with peers Setting Events (if Applicable): Behavior Verbal Aggression Physical Aggression Property Destruction Maintaining Consequence Peers give up toy/item Peers leave area Adults intervene with negative attention Handout 4 & 5

Behavior Support Plan DevelopmentStep Two • Identify the function of Michael’s challenging behavior. Trigger Group play: outside play with peers Setting Events (if Applicable): Behavior Verbal Aggression Physical Aggression Property Destruction Function: Obtain Toy/Attention Maintaining Consequence Peers give up toy/item Peers leave area Adults intervene with negative attention

Michael’s Hypothesis Statement Remember: • Triggers of the challenging behavior • Description of the challenging behavior • Function of the behavior • Responses that maintain the challenging behavior In group play situations (outside play/centers),... Michael uses verbal aggression (threats), physical aggression (hit, push, kick, punch), and property destruction (throwing or banging toys)… to obtain toys and/or join play. When this occurs, the peer relinquishes the desired toy and leaves the play area and/or an adult intervenes and provides Michael with excessive negative attention.

Step 3: Preventions • Pre-teach skills via scripted story. • Use visual cards to help him remember lessons when in difficult situation. Trigger Group play: outside play with peers Setting Events (if Applicable): Behavior Verbal Aggression Physical Aggression Property Destruction Function: Obtain Toy/Attention Maintaining Consequence Peers give up toy/item Peers leave area Adults intervene with negative attention Preventions Pre-teach skills by role playing via scripted story Use visual cards to help him remember lessons when in difficult situation Self-monitoring form to work on new skills Replacement Skills New Responses

Step 4: Replacement Skills • Asking to play, Everyone can play with the toys, Flexibility, accepting other’s ideas/space, Asking for teacher’s help, Self-monitoring form to work on social goals. Trigger Group play: outside play with peers Setting Events (if Applicable): Behavior Verbal Aggression Physical Aggression Property Destruction Function: Obtain Toy/Attention Maintaining Consequence Peers give up toy/item Peers leave area Adults intervene with negative attention Preventions Pre-teach skills by role playing via scripted story Use visual cards to help him remember lessons when in difficult situation Self-monitoring form to work on new skills Replacement Skills Asking to play Everyone can play with the toys Asking for teacher’s help New Responses

Step 5: New Responses • Immediately respond to his requests for help. • Intervene to prevent harm by providing attention/support to child who is attacked. • Provide certificate and acknowledge positive behavior at end of each day for successfully achieving goals. Trigger Group play: outside play with peers Setting Events (if Applicable): Behavior Verbal Aggression Physical Aggression Property Destruction Function: Obtain Toy/Attention Maintaining Consequence Peers give up toy/item Peers leave area Adults intervene with negative attention Preventions Pre-teach skills by role playing via scripted story Use visual cards to help him remember lessons when in difficult situation Self-monitoring form to work on new skills New Responses To Challenging Behavior: Anticipate & cue to use new skill. Intervene to prevent harm by providing attention/support to child who is attacked To Use of New Skill: When asks, respond Provide certificate/star and acknowledge positive behavior. Fade certificate/star Replacement Skills Asking to play Everyone can play with the toys Asking for teacher’s help

Step 6: Intentional Implementation Action Planning Form Child Name: Michael Program: Village Pre-K Date: 10/11 Planning Objectives: Develop behavior support plan materials to assist Tim at home and in preschool

Action Planning Form (con’t.)

Action Planning Form (con’t)

Implementation • Teach classroom staff/family/other adults – review strategies, demonstrate or guide, provide reinforcement (not criticism). • Make sure everyone on the team understands the plan. • Design supports that help the adults remember the plan (posted mini-plan, reminder signs, checklists). • Be cautious about extinction bursts– offer support, availability. • Ask for time, assure classroom staff/family that you are committed to creating a plan that will work. • Begin plan implementation when all pieces have been developed (behavior support plan, materials, activity/routine matrix, instructional procedures, and outcome monitoring form).

Monitoring Outcomes • Helps determine the impact of the behavior support plan (or lack of impact!) • Allows you to alter the plan as needed • Remember to KISS it!

Michael’s Playtime 2 Fussed, took several turns 4 Laughing, stayed 3 Cooperated, stayed briefly 1 Cried, refused to play

Average Aggression Child’s Name: __Michael____ Week of: ___4/1/13-4/5/13_________ Check the number of times the child is aggressive during the activity. Aggression includes: hits, pinches, pulls hair, bites, kicks, & scratches.

Child’s Transitions Week of: _________________ .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 .8 Rate the problem behavior: 0 = no problems, 1 = whining, resisting, 2 = screaming, falling on floor, 3 = screaming, hitting, other aggression

If Challenging Behavior Returns • First • Review plan and make sure it is being implemented as planned. • Review evaluation data to determine if the pattern is an extinction burst (worse before it gets better). • Examine events to see if there are new triggers for behavior. • Then • Restore support plan and implement with fidelity; or • Continue plan through extinction burst; or • Add components to plan to address new triggers; or • Conduct a new functional assessment and develop new support strategies.

Behavior Support Planning