Welcome!

1. Welcome!

2. Polk County Positive Behavior Support (PBS) Academy PBS 101

3. Training Objectives • To learn what PBS is as both philosophy and tools • Learn the basics of how we set the tone for the environment-to help or hinder • Learn basic tools of PBS • Learn how to use data to drive decisions

4. What is PBS • It is a philosophy and a set of tools • A way of thinking and doing • Positive behavior support offers a proactive process for • addressing behavioral challenges, • teaching adaptive skills, and • improving quality of life.

5. Polk County PBS Mission & Values • We are an inter-agency coalition promoting positive support to enhance the quality of life for persons with disabilities. • We make decisions based on: • Dignity & respect • Long-term commitment • System consistency • Person-centered • Empowerment through training, support, & education • Reducing the need for right restrictions • Promoting full citizenship and the exercise of choice

6. Link Associates’ Mission Statement • Providing people with mental disabilities opportunities to achieve their personal goals. Link Associates’ Values • Dignity & Respect • Quality Services • Caring Environments • Personal Choice • Long Term Commitment

7. Insert Agency PBS Policy

8. Section One: Philosophy

9. How you see me!

10. How I want to live!

11. TARGET BEHAVIOR Universal Enhancement Strategies Gardening Dancing Religion Hiking Pets Sex Music Spontaneity Work Fishing Day at the spa Grilling out Good Health Dining out Family Vacationing Volunteering Exercising Movies Voting Having a will Friends Things of Value Positive rituals

12. GEM • Good Enough for Me –Tom Pomerantz

13. I have come to the frightening conclusion that I am the decisive element in my environment. It is my personal approach, which creates the climate. My daily mood makes the weather. I possess tremendous power to make a person’s life miserable or joyous. I can be a tool of torture or an instrument of inspiration. I can humiliate or humor, hurt or heal. In all situations, it is MY response that decides whether a crisis will be escalated or de-escalated and a person humanized or dehumanized. ( Adapted- HalmGinott)

14. Life We must provide an environment that is healthy enough for a life to happen. Dan Berkowitz

15. Effective Behavioral Support ..requires the design of an environment that makes problem behaviors: Irrelevant Ineffective Inefficient

16. Prove It! • Prove that: • treating people with • dignity and respect • meeting unmet needs • bonding • decreases the frequency • and intensity of • challenging behavior. • Does it Matter?!

17. Respect – Fundamental to PBS • A personal quality that is non-contingent provided without judgment and given equally to all persons. • People should not have to earn your respect they should be the recipient of your respect without condition.

18. Defining Characteristics of PBS • Person centered • Collaborative on-going process • Data-driven decision making • Prevention, positive, proactive strategies • Meaningful outcomes

19. IS NOT Simple Short term Just Decrease Behavior Reactive Aversive (punish) Observable Behavior Experts Decide IS Comprehensive Long term Teach Useful Skills Proactive Positive (reinforce) Function Involve Individual

20. If an individual doesn’t know how to read, we teach. If an individual doesn’t know how to swim, we teach. If an individual doesn’t know how to multiply, we teach. If an individual doesn’t know how to drive, we teach. If an individual doesn’t know how to behave, we…………………teach?.................punish? Why can’t we finish the last sentence as automatically as we do the others? Tom Herner (NASDE President, Counterpoint 1998, p.2)

21. Break

22. Section 2: ToolsHow we get to a Life!

23. Step One Step Two Step Three Step Four Gather Information Develop a Hypothesis Build a Support Plan Evaluate effectiveness and modify support plan as needed Four Steps to Designing an Effective Behavior Support Plan

24. Step 1: Gather Information • Person Centered Planning • Get to know the person

25. Five Essential Goals of Person Centered Planning • Expressing preferences and making choices in everyday life • Gaining and maintaining satisfying relationships • Having opportunities to fulfill respected roles and live in dignity • Being present and participating in community life • Continuing to grow

26. Characteristics of Person-Centered Planning • Includes focuses on the individual • Respects the individual and their dreams and choices • Emphasizes strengths, abilities, and capacities • Strength based Training principles • Individualized supports • Empowers the consumer and team

27. Tools for Person-centeredPlanning • Essential Lifestyle plan • Insert tool your agency uses.

28. What is behavior? • Anything a person says or does • 90% of behavior is communication • Must be observable and measurable • Must meet the “dead man’s test” *If a dead man can do it, it’s NOT behavior

29. Behavior is method of: communication both verbally & physically of hopes, dreams, fears, anxieties, preferences, intentions and prioritiesBehavior is also a method to: cope with or respond to demands from others control and impulses, conform to generally accepted social conduct, and or influences of the environmentBehavior is the result of complex neurological and sensory process.

30. He Had A Behavior Of course he had a behavior! If he didn’t he’d be DEAD! There is: walking behavior talking behavior sitting behavior standing behavior smiling behavior eating behavior Have you ever been outside when there wasn’t any weather?

31. Behavioral Definition • Definition of behavior needs to be clear, concise, and specific • A description of what you will see when the behavior occurs. • Written so that everyone can agree when the behavior occurs.

32. Examples high-pitched scream Kicks chair over Hits others/self Completes tasks Non-Examples Poor impulse control Angry, frustrated Aggressive Pay attention Specific Target Behaviors

33. Lack of Understanding To call someone lazy, uncooperative or stubborn is to admit we don’t understand them. She’s just plain stubborn. She refused to take her meds again!

34. Step 1: Gather Information Functional Assessment

35. What is Functional Assessment • A functional assessment is a process for identifying clear, predictive relationships between events in a person’s environment and occurrences of a challenging behavior. • Not a data collection form • Not an event

36. Why Conduct a Functional Assessment? • provides clear information • allows strategies to be based on the function(s) of challenging behavior • leads to more durable outcomes • reduces the need for reactive interventions and crisis plans • addresses the needs of an individual • increases quality of life

37. Find answers to the BIG Questions • Under what conditions do the challenging behaviors occur? • What are the outcomes? • Under what conditions do the challenging behaviors not occur

38. A Functional Assessment Identifies Goals of Intervention • Defines specific target behaviors to increase and decrease • Pinpoints circumstances in which intervention will occur • Identifies desired lifestyle changes, such as • Participation in integrated activities • Enhanced independence and satisfaction • Expanded social networks • Work!!! 

39. What are the basics? • Gather information about the challenging behavior through direct observation, interviews, record reviews and/or rating scales • Develop a hypothesis after analyzing the information regarding the variables that starts and maintains behavior

40. Group Work • Worksheet 1

41. The ABC’s of a Functional Behavioral Assessment • Setting Event the state a person is in, e.g., the person is tired, or hungry; a state that predisposes a person to behave in a certain way given a particular antecedent. • Antecedents any stimulus which precedes a behavior occurrence • Behaviors any observable act of an individual; the activity one performs in the presence of a particular stimulus • Consequences the events which occurred following behavior

42. What are Consequences? Consequences are events that follow a behavior. Positive or Negative

43. Results or Functions of Behavior Get Sensory Attention Tangible Get Away Sensory Attention Tangible

44. Results or Functions of Behavior • Sensory • Escape • Attention • Tangible • Meet an unmet need

45. Why do people display challenging behaviors? • Biological/Medical Reasons: • Drugs/medicine • Seizure activity • Allergies/hormonal changes • To mask pain or discomfort • Self-Regulation • To maintain a level of arousal • Reaction to a change in sensory input

46. Reinforcement: • Internal-it feels good • External-to serve a purpose in one’s environment • Absence of Alternative Skill • Most behaviors have the goal to communicate • Messages are sent through behavior • Control is the key word

47. Practice the ABC’s Which is the Antecedent, Behavior and the Consequence in each of these examples. • 1. During dinnertime, Ben watches the staff pass the tea pitcher to a peer. Ben then passes the water pitcher to the staff, who says “ Thank you” to Ben. • 2. Betty repeatedly teases Samantha. Following the teasing remark, Samantha throws a magazine at Betty. The staff tells Samantha not to throw things. • 3. A staff person tells Natasha that a visitor will be visiting her in a few minutes. Natasha puts on a new dress. The visitor tells Natasha how nice she looks

48. Alternative Behaviors • What is the best way to decrease a behavior that is a barrier to getting a life? • Find an alternative behavior that serves the same function or purpose – gets the same results.

49. Competing Behavior Pathway Desired Behavior Consequence Setting Event Antecedent Problem Behavior Consequence Alternative Behavior

50. Competing Behavior Pathway Desired Behavior Typical Consequences Interact nicely; do what’s asked Staff positive attention, Asked to do something Problem Behavior Setting Events Triggering Antecedents Maintaining Consequences Scream, Hit head Approach by Staff Staff move away; avoid request Tired Acceptable Replacement Behavior