Managing the Behavior of Children with Autism in Inclusive Classrooms

1. Managing the Behavior of Children with Autism in Inclusive Classrooms Brian A. Boyd, Ph.D. Frank Porter Graham Child Development Institute University of North Carolina Inclusion Institute, Chapel Hill, NC

2. Overview of Presentation • Characteristics of Autism & Problem Behavior • Managing Problem Behavior • Preventing problem behavior • Replacing problem behavior • Responding to problem behavior • Summary & Questions

3. What is Autism? • Autism is a neurodevelopmental disorder • Autism is the second most common developmental disability • 4-5 times more prevalent in boys than girls • Occurs on a behavioral continuum • 75-80% of individuals have mental retardation • 15-20% have average or above average intelligence Dimensions of Autism IQ HI Age Mild Symptoms Severe LO

4. Characteristics of Autism Social Communication Repetitive Behavior

5. Types of Problem Behavior Associated with Autism • Social Difficulties • Escape/refuse social interaction • Inappropriate initiation strategies • Communication Difficulties • Repetitive question asking • Inappropriate comments to strangers • Repetitive and/or Problem Behavior • Repetitive hand flapping or object use • Aggression or SIB

6. Usual Intervention Strategies Observable Behaviors Proactive REACTIVE

7. Re-thinking Problem Behavior in Autism • Not socially interacting • Aggressive towards peers • Lack appropriate social initiation strategies • Lack of social motivation Division TEACCH

8. Re-thinking Problem Behavior in Autism • Repetitively dumps or pours objects • Repetitively rocks or hand flaps • Lack appropriate pretend play skills • Need sensory input Division TEACCH

9. What Makes Inclusion Difficult for Children with Autism? • Peer interaction • Learning via peer modeling • Emphasis on verbal communication • Environmental distractions

10. What Makes Inclusion Possible for Children with Autism? • Our ability to put the appropriate supports into place • Our ability to manage problem behavior Managing Problem Behavior Pyramid

11. Preventing Problem Behavior 1. Arrangement of Classroom Environment 2. Predictability of Classroom Activities 3. Appropriate Behavior Communicates

12. 1. Arrangement of Classroom Environment

13. What is Classroom Arrangement? • Physical set-up / organization of the classroom • Is the classroom set-up in a manner that cues appropriate behavior? • Availability of appropriate classroom materials and toys • Are materials & toys developmentally appropriate? • Learning environment • Are distractions minimized & environment engaging?

14. Things to Think About When Physically Arranging the Classroom • Characteristics of the child • What are his / her social, communication, & play skills? • Is the classroom structured for the child who has the most intense needs? • Well-defined activity centers • Physical boundaries? • Additional centers (e.g. sensory, independent work)? • Availability of developmentally and age-appropriate play materials • Cause and effect toys or ones that are easier to manipulate? • Sensory-based toys?

15. Additional Questions to Consider • Physical Environment & Classroom Structure • Is there a fluid traffic pattern in the classroom? • Does the classroom have learning centers? • Is there structure and organization for seated activities? • How structured is the unstructured play and physical activity? • Is there adequate teacher supervision? (e.g. teacher-to-child monitoring; zone monitoring)?

16. Additional Questions cont’d • Toys and Materials • Are the toys and materials developmentally appropriate? • Are there enough toys and materials? • Are toys and materials organized and accessible to the children? • Are the children’s preferences included in the choice of toys and materials?

17. Additional Questions cont’d • Distractions • Are distractions kept to a minimum (e.g. phones, intercom, and teacher traffic)? • Are learning areas visually distracting to the children? • Is there an appropriate level of noise in the classroom?

18. Additional Questions cont’d • Learning Environment • Are learning opportunities organized and structured throughout the day? • Does the teacher have a daily lesson plan? If so, is the plan followed?

19. 2. Predictability of Classroom Activities

20. What is Classroom Predictability? • Classroom rituals & routines • How predictable are they? • How can we make them more predictable? • Classroom schedules • Are classroom daily schedules available (“between-activity” schedules)? • Are activity schedules available (“within-activity” schedules)?

21. Rituals, Routines and Challenging Behaviors • Rituals and routines (R & R) provide stability and consistency • R & R communicate values such as friendship, caring, or responsibility • R & R serve as rule reminders • R & R create a sense of community

22. Using Rituals and Routines • Transition times • Hello/Good-bye Song • As a rule reminder • Criss-Cross Applesauce • Times of crisis • Breaking the coercive pattern & redirection • As often as you want • Fun!

23. First Then Building Routines:First-Then Contingency Systems First Then

24. Schedules • Daily schedules should provide consistency for the children • Daily schedules should follow a “natural ebb and flow” to encourage appropriate behavior • Daily schedules should become “routine” and predictable for the children (Colvin & Lazar, 1997).

25. Daily Visual Schedules “Between Activity” • Photographic or picture schedules provide concrete, visual cues of the scheduled routine (Massey & Wheeler, 2000). • Changes to the schedule or special events (field trip, visitor, substitute teacher) require specific photos or pictures to cue children.

26. Types of Visual Schedules • Object schedule • Photo schedule • Line drawing schedule • Written word schedule • Technology-based schedule (e.g. PDA)

27. “Within” Activity Schedules • “Between” activity schedules take the child from place to place in the classroom (e.g. circle to snack) • “Within” activity schedules tell the child what to do once they get to the place

28. Things to Think About when Creating a Schedule • What type of schedule should you use? • How is the schedule arranged (top-down v. left-right)? • How much information to include on schedule? • How to introduce flexibility into schedule? • Does everyone’s schedule look the same?

29. Other Preventative Visuals • Use of Other “Helpful” Visuals • Hand prints • Foot prints • Wait (visual timer) • “Finished” or “All done” basket

30. 3. Appropriate Behavior Communicates

31. Challenging BehaviorCommunicates • Children engage in challenging behavior because “it works” for them • Challenging behavior results in the child gaining access to something or someone (i.e., obtain/request) or avoiding something or someone (i.e., escape/protest) Positive Beginnings Project

32. Communication of Children with Autism • Children with autism need… • Means to communicate • PECS, language, written words, AAC • Motivation to communicate • Early, appropriate communicative attempts should center around and result in access to powerful and natural reinforcers Division TEACCH

33. Putting Prevention into Practice • Think of 1 child with or without autism in your classroom who exhibits problem behavior • Write down 1 prevention strategy • Arrangement of classroom environment • Predictability of classroom activities (routines & rituals) • Appropriate behavior communicates • Sharing Time 

34. Managing Problem Behavior Pyramid

35. Basic Behavioral Principles Stimulus (S)/ Antecedent (A) Response (R)/ Behavior (B) Reinforcer (R)/ Consequence (C) Allow child to stay in same activity Transition time Tantrum Behavioral History

36. Basic Behavioral Principles

37. Basic Behavioral Principles (cont’d) • Setting Event–event that occurs at another time in the child’s environment that increases the likelihood the child will engage in challenging behavior. Setting events serve to “set the child up” to have challenging behavior. Positive Beginnings Project

38. Some Potential Setting Events • Change in Medications • Lack of Sleep • Hunger • Argument with Parent • Unpredictable Environment • Little Forewarning of Transitions • Presence of Certain People • Others?? Positive Beginnings Project

39. Guiding Behavioral Principles • Vast majority of appropriate and inappropriate behaviors are learned. • Problem behaviors are related to the context in which they occur. • Problem behaviors serve some function for the student. • Effective interventions are based on a thorough understanding of the student, the context, and the function of the problem behavior. Delaware PBS Project

40. What are the Functions of Behavior? • Individual’s engage in problem behavior for two basic purposes: • To “obtain” something in their environment • To “escape” something in their environment • What do we obtain? • Tangible items (e.g., toys, access to remote control) • Attention (e.g., from peers, parents, teachers) • Internal sensory consequences--”it just feels good” (e.g., deep tissue massage, visual stimulation) • What do we escape? • Aversive situations (e.g., tasks, demands) • Internal sensory consequences--”it doesn’t feel good” (e.g., headaches)

41. Let’s Play Guess that Function

42. Amir • Amir, a 3 year old with autism, has a temper tantrum when he sees another child in his class with a Sponge Bob toy. The teacher has to say “You can’t have that toy, it belongs to someone else.” Amir continues to cry and tantrum, becoming very disruptive. Typically, class peers say to the teacher “I’ll share my toy with Amir.” The teacher agrees. Amir takes the toy and immediately stops the tantrum. ____ ____ ____ ____ ____ ____ ____ ____ 8 letter word Positive Beginnings Project

43. Sharif • Sharif is a kindergartner with high functioning autism. Sharif is very bright and knows the answers to many of the teacher’s questions but has difficulty waiting his turn, raising his hand, and speaking in a normal tone of voice. He is constantly talking out of turn in class. The teacher finds this very disruptive to her lessons. When Sharif blurts out the answer, often the teacher responds “That is right Sharif, but let someone else have a turn.” When the teacher says this, Sharif blurts out another answer. ____ ____ ____ ____ ____ ____ ____ ____ ____ 9 letter word

44. Hoyeon • Hoyeon, a 6 year old girl who has autism, swings high & fast on the outdoor swing set incessantly during recess. Occasionally, children in the class approach Hoyeon on the playground, but she either pushes them away or doesn’t respond. Eventually, they stop approaching her. When the teacher suggests to the other children that they might play with Hoyeon, the children say that Hoyeon doesn’t want to play and continue to play with each other. Hoyeon continues to engage in this behavior daily taking no notice of the other children. ____ ____ ____ ____ ____ ____ ____ 7 letter word

45. Replacing Problem Behavior To replace problem behavior you want to make it Irrelevant, Inefficient, and Ineffective. (O’Neill et al., 1997)

46. Replacing Problem Behavior cont’d • Problem behaviors are irrelevant when Child doesn’t need to escape anymore Child has access to positive events more commonly • Problem behaviors are inefficient when Alternative behavior is available Alternative behavior is taught • Problem behaviors are ineffective when Problem behavior NO LONGER works--it does not get the child what they want to obtain or what they want to avoid. Delaware PBS Project

47. Desired Alternative Maintaining Consequence INTERVENTIONPATHWAY Maintaining Consequence Setting Events Triggering Antecedents Problem Behavior Acceptable Behavior SUPPORT PLANNING Setting Event Manipulations Antecedent Manipulations Behavior Teaching Consequence Modifications

48. Behavior Support Plan Components: • Prevention Strategies • Modify setting events and antecedents (i.e., triggers) to reduce the likelihood that the problem behavior will occur and increase the likelihood that an appropriate alternative skill will be used. • Teaching Strategies • Teach the appropriate alternative skill. • Consequence Strategies • Maximize the use consequences to strengthen the use of appropriate skills and reduce the occurrence of problem behaviors. Delaware PBS Project

49. Design a Behavior Support Plan: Preventative Strategies AKA: Make the problem behavior irrelevant What modifications to the environment (academic, social, physical) may PREVENT the problem behavior? What adjustments will make the problem behavior unnecessary? Delaware PBS Project

50. Examples ofPreventative Strategies Increase the effectiveness of instruction for this child (Direct Instruction, Small group or Individualized Instruction) Increase academic skill levels (Ongoing assessment to ensure instructional match & success) Modify the curriculum (Interests, preferences, choice, sequence) Modify the demands (Quantity, difficulty, presentation, alternative tasks) Clarify the expectations and make environment predictable (Use of schedule, charts w/ visual cues of steps) Reorganize the physical & interaction setting (Use physical boundaries, pair or independent seats, change seating of students) Delaware PBS Project