Positive Behavioral Supports

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Developed to prepare direct support staff to implement Positive Behavioral Support Plan for individuals with developmental disabilities. Introduces the basic concepts, terminology, and strategies behind positive behavioral supports. Some Connecticut-specific language - amend to your particular state as desired.

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  • Obviously, individuals with a developmental disability, have impaired cognitive development. As a result, their ability to assimilate and accommodate new information may be somewhat or severely limited. As support staff, we need to remember this fact as we set our expectations of individuals – their ability to follow multi-step directions, their ability to learn and remember new independent living skills and pro-social skills.
  • In classical conditioning, the unconditioned stimulus is one that unconditionally, naturally, and automatically triggers a response. For example, when you smell one of your favorite foods, you may immediately feel very hungry. In this example, the smell of the food is the unconditioned stimulus. The unconditioned response is the unlearned response that occurs naturally in response to the unconditioned stimulus. For example, if the smell of food is the unconditioned stimulus, the feeling of hunger in response to the smell of food is the unconditioned response. The conditioned stimulus is previously neutral stimulus that, after becoming associated with the unconditioned stimulus, eventually comes to trigger a conditioned response. For example, suppose that the smell of food is an unconditioned stimulus and a feeling of hunger is the unconditioned response. Now, imagine that when you smelled your favorite food, you also heard the sound of a whistle. While the whistle is unrelated to the smell of the food, if the sound of the whistle was paired multiple times with the smell, the sound would eventually trigger the conditioned response. In this case, the sound of the whistle is the conditioned stimulus. The conditioned response is the learned response to the previously neutral stimulus. For example, let's suppose that the smell of food is an unconditioned stimulus, a feeling of hunger in response to the smell is a unconditioned response, and a the sound of a whistle is the conditioned stimulus. The conditioned response would be feeling hungry when you heard the sound of the whistle.
  • Notice how one arm goes over the other with it's hand tucked under it's biceps (upper arm). At the same time, the hand of the lower arm has it's hand resting on top of the biceps of the other limb.
  • Serve The Same Purpose – communicate frustration, anxiety, fear, desire, pain, etc Payoff/Reinforcement – provide a benefit to the individual (alleviate anxiety, task avoidance, provide attention, provide sexual gratification, etc.) As Soon or Sooner – payoff/reinforcement is time-dependent. If payoff/reinforcement will take too long, the individual’s frustration or anxiety will escalate which means, in their mind, the replacement behavior isn’t as effective as the challenging behavior – it doesn’t get them what they want. As Much or More - payoff/reinforcement is intensity-dependent. If payoff/reinforcement does not have the same emotional satisfaction, the individual’s frustration or anxiety will escalate which means, in their mind, the replacement behavior isn’t as effective as the challenging behavior – it make them feel like they want. Just As Easy or Easier - payoff/reinforcement is effort-dependent. If payoff/reinforcement is too hard, the individual’s frustration or anxiety will escalate which means, in their mind, the replacement behavior isn’t as effective as the challenging behavior.
  • After presenting this slide, review the handout, “ Functional Assessment and Positive Behavioral Support Plan ” for Joe Consumer: Psychological & Psychosocial Assessments (Pages 1-3) Diagnoses Rationale for Interventions Long Term Goals & Short Term Objectives Functional Analysis of Behaviors Strengths & Assets Challenging Behaviors, Reinforcements, Pro-Social Skills (Pages 6-9) Positive Targeted Behaviors Behaviors of Concern and Definitions Functional Analysis of Behaviors of Concern Intervention Approaches/Strategies (Pages 9-12)
  • Gentle Teaching – if the individuals don’t feel safe (fear, anxiety), they won’t feel loved (loneliness) – which means they won’t be loving toward others, which means they won’t be able to feel fully engaged in their community Active Listening Proactive – make time each day to talk with the individual in order to develop a relationship with them and to show them you care Reactive – sit down with them, give them your full attention, listen to what they’re saying with their words, their body language, their actions (remember that challenging behavior is communication), repeat what they said back to them so they know you are listening Validation – validate their feelings, let them know it’s ok to be angry, anxious, upset, depressed. You don’t have to agree with the way they feel or the way they’re expressing their feelings – just let them know you understand they feel the way they do. Positive Attribution – our goal is the reinforce the individual’s pro-social skills by praising them and providing them with extra, positive attention when they display these skills. Use the PBS terminology consistently to hammer home the point – “I really like that you didn’t interrupt Brian while he was talking. You’re definitely a “responsible guy.” I’m proud of you!”
  • Positive Behavioral Supports

    1. 1. Positive Behavioral Supports The Most Important Piece of the Puzzle
    2. 2. Positive Behavioral Supports <ul><li>What Is The Goal Of Positive Behavioral Supports? </li></ul><ul><li>What Are The Challenges of Positive Behavioral Supports? </li></ul><ul><li>How Do We Help Individuals Who Display Disruptive Behaviors? </li></ul>
    3. 3. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? <ul><li>In order to understand the concept of Positive Behavioral Supports, we must first understand the psychology behind behavior. </li></ul><ul><ul><li>Why do people behave the way they do? </li></ul></ul><ul><ul><li>What factors contribute to people’s behaviors? </li></ul></ul><ul><ul><li>Is it possible for people who behave one way to learn to </li></ul></ul><ul><ul><li>behave another way? </li></ul></ul>
    4. 4. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Behavioral Psychology 101 Cognitive Theory of Development Cognitive theory is concerned with the development of a person's thought processes. It also looks at how these thought processes influence how we understand and interact with the world. The foremost cognitive thinker was Jean Piaget. Cognitive development involves changes in cognitive process and abilities. In Piaget’s view, early cognitive development involves processes based upon actions and later progresses into changes in mental operations. Why do people behave the way they do?
    5. 5. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Why do people behave the way they do? Behavioral Psychology 101 Cognitive Theory of Development Key Concepts Schemas – A child may have a schema about a type of animal, such as a dog. If the child’s sole experience has been with small dogs, a child might believe that all dogs are small, furry, and have four legs. Suppose then that the child encounters a very large dog. The child will take in this new information, modifying the previously existing schema to include this new information.
    6. 6. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Why do people behave the way they do? Behavioral Psychology 101 Cognitive Theory of Development Key Concepts Assimilation – The process of taking in new information into our previously existing schema’s is known as assimilation. In the previous example, seeing a dog and labeling it “dog” is an example of assimilating the animal into the child’s dog schema. Accommodation – Another part of adaptation involves changing or altering our existing schemas in light of new information, a process known as accommodation. Accommodation involves altering existing schemas, or ideas, as a result of new information or new experiences. New schemas may also be developed during this process.
    7. 7. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Why do people behave the way they do? Behavioral Psychology 101 Psychosocial Development One of the main elements of Erik Erikson’s psychosocial stage theory is the development of ego identity. Ego identity is the conscious sense of self that we develop through social interaction. According to Erikson, our ego identity is constantly changing due to new experience and information we acquire in our daily interactions with others. In addition to ego identity, Erikson also believed that a sense of competence also motivates behaviors and actions. Each stage in Erikson’s theory is concerned with becoming competent in an area of life. If the stage is handled well, the person will feel a sense of mastery, which he sometimes referred to as ego strength or ego quality. If the stage is managed poorly, the person will emerge with a sense of inadequacy.
    8. 8. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Why do people behave the way they do? Behavioral Psychology 101 Psychosocial Development Psychosocial Stage 1 - Trust vs. Mistrust The first stage of Erikson’s theory of psychosocial development occurs between birth and one year of age and is the most fundamental stage in life. Because an infant is utterly dependent, the development of trust is based on the dependability and quality of the child’s caregivers. If a child successfully develops trust, he or she will feel safe and secure in the world. Caregivers who are inconsistent, emotionally unavailable, or rejecting contribute to feelings of mistrust in the children they care for. Failure to develop trust will result in fear and a belief that the world is inconsistent and unpredictable.
    9. 9. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Why do people behave the way they do? Behavioral Psychology 101 Psychosocial Development Psychosocial Stage 2 - Autonomy vs. Shame and Doubt The second stage of Erikson's theory of psychosocial development takes place during early childhood and is focused on children developing a greater sense of personal control. Like Freud, Erikson believed that toilet training was a vital part of this process. However, Erikson's reasoning was quite different then that of Freud's. Erikson believe that learning to control one’s body functions leads to a feeling of control and a sense of independence. Other important events include gaining more control over food choices, toy preferences, and clothing selection. Children who successfully complete this stage feel secure and confident, while those who do not are left with a sense of inadequacy and self-doubt
    10. 10. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Why do people behave the way they do? Behavioral Psychology 101 Psychosocial Development Psychosocial Stage 3 - Initiative vs. Guilt During the preschool years, children begin to assert their power and control over the world through directing play and other social interaction. Children who are successful at this stage feel capable and able to lead others. Those who fail to acquire these skills are left with a sense of guilt, self-doubt and lack of initiative
    11. 11. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Why do people behave the way they do? Behavioral Psychology 101 Psychosocial Development Psychosocial Stage 4 - Industry vs. Inferiority This stage covers the early school years from approximately age 5 to 11. Through social interactions, children begin to develop a sense of pride in their accomplishments and abilities. Children who are encouraged and commended by parents and teachers develop a feeling of competence and belief in their skills. Those who receive little or no encouragement from parents, teachers, or peers will doubt their ability to be successful.
    12. 12. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Why do people behave the way they do? Behavioral Psychology 101 Psychosocial Development Psychosocial Stage 5 - Identity vs. Confusion During adolescence, children are exploring their independence and developing a sense of self. Those who receive proper encouragement and reinforcement through personal exploration will emerge from this stage with a strong sense of self and a feeling of independence and control. Those who remain unsure of their beliefs and desires will feel insecure and confused about themselves and the future.
    13. 13. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Why do people behave the way they do? Behavioral Psychology 101 Psychosocial Development Psychosocial Stage 6 - Intimacy vs. Isolation This stage covers the period of early adulthood when people are exploring personal relationships. Erikson believed it was vital that people develop close, committed relationships with other people. Those who are successful at this step will develop relationships that are committed and secure. Remember that each step builds on skills learned in previous steps. Erikson believed that a strong sense of personal identity was important to developing intimate relationships. Studies have demonstrated that those with a poor sense of self tend to have less committed relationships and are more likely to suffer emotional isolation, loneliness, and depression.
    14. 14. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Why do people behave the way they do? Behavioral Psychology 101 Psychosocial Development Psychosocial Stage 8 - Integrity vs. Despair This phase occurs during old age and is focused on reflecting back on life. Those who are unsuccessful during this phase will feel that their life has been wasted and will experience many regrets. The individual will be left with feelings of bitterness and despair. Those who feel proud of their accomplishments will feel a sense of integrity. Successfully completing this phase means looking back with few regrets and a general feeling of satisfaction. These individuals will attain wisdom, even when confronting death.
    15. 15. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? <ul><li>Why do people behave the way they do? </li></ul><ul><li>Behavioral Psychology 101 </li></ul><ul><li>Behavioral psychology, also known as behaviorism, is a theory of </li></ul><ul><li>learning based upon the idea that all behaviors are acquired through </li></ul><ul><li>conditioning. Conditioning occurs through interaction with the </li></ul><ul><li>environment. </li></ul><ul><li>There are two major types of conditioning: </li></ul><ul><ul><li>Classical conditioning is a technique used in behavioral training </li></ul></ul><ul><ul><li>in which a naturally occurring stimulus is paired with a response. </li></ul></ul><ul><ul><li>Operant conditioning Operant conditioning (sometimes referred </li></ul></ul><ul><ul><li>to as instrumental conditioning) is a method of learning that </li></ul></ul><ul><ul><li>occurs through rewards and punishments for behavior. Through </li></ul></ul><ul><ul><li>operant conditioning, an association is made between a </li></ul></ul><ul><ul><li>behavior and a consequence for that behavior. </li></ul></ul>
    16. 16. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Why do people behave the way they do? Behavioral Psychology 101 Classical Conditioning Have you ever heard someone compare something to &quot;Pavlov's dogs&quot; and wondered exactly what the reference means? The phrase refers to an accidental discovery by physiologist Ivan Pavlov, who found that dogs could be conditioned to salivate to the sound of a bell. This process, known as classical conditioning, became a fundamental part of behavioral psychology.
    17. 17. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Why do people behave the way they do? Behavioral Psychology 101 Operant Conditioning In addition to conditioning natural responses through association, behaviorist B.F. Skinner described a process in which learning could occur through reinforcement and punishment. This process, known as operant conditioning, functions by forming an association between a behavior and the consequences of the behavior.
    18. 18. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Behavioral Psychology 101 <ul><li>What factors may negatively impact an individual’s </li></ul><ul><ul><li>Cognitive Development </li></ul></ul><ul><ul><li>Psychosocial Development </li></ul></ul><ul><ul><li>Conditioning </li></ul></ul><ul><li>and possibly contribute to that individual developing problematic or disruptive behaviors? </li></ul>What factors contribute to people’s behaviors?
    19. 19. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Cognitive Development <ul><ul><li>Intellectual/Developmental Disability </li></ul></ul><ul><ul><ul><li>Mental Retardation, Autism, Traumatic Brain Injury, Fetal Alcohol </li></ul></ul></ul><ul><ul><ul><li>Syndrome </li></ul></ul></ul><ul><ul><li>Mental Health Disorders </li></ul></ul><ul><ul><ul><li>Depression, Bipolar, Anxiety Disorders, Schizophrenia, Psychotic </li></ul></ul></ul><ul><ul><li>Chromosomal Disorders </li></ul></ul><ul><ul><ul><li>Downs Syndrome, Fragile X, </li></ul></ul></ul><ul><ul><ul><li>Pervasive Developmental Disorder (PDD) </li></ul></ul></ul>
    20. 20. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Psychosocial Development <ul><ul><li>Trust vs. Mistrust </li></ul></ul><ul><ul><ul><li>Because an infant is utterly dependent, the development of trust is based on the dependability and quality of the child’s caregivers. </li></ul></ul></ul><ul><ul><ul><li>Caregivers who are inconsistent, emotionally unavailable, or rejecting </li></ul></ul></ul><ul><ul><ul><li>Failure to develop trust will result in fear and a belief that the world is inconsistent and unpredictable . </li></ul></ul></ul>
    21. 21. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Psychosocial Development <ul><ul><li>Trust vs. Mistrust </li></ul></ul><ul><ul><ul><li>Parents/family members who were </li></ul></ul></ul><ul><ul><ul><ul><li>inconsistent (worked multiple jobs, paid little attention) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>emotionally unavailable (own mental health issues, unloving) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>rejecting (not encouraging, critical, negative, abusive) </li></ul></ul></ul></ul><ul><ul><ul><li>Friends/peers who were the same </li></ul></ul></ul>
    22. 22. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Psychosocial Development <ul><ul><li>Autonomy vs. Shame & Doubt </li></ul></ul><ul><ul><ul><li>Learning to control one’s body functions leads to a feeling of control and a sense of independence. Other important events include gaining more control over food choices, toy preferences, and clothing selection. </li></ul></ul></ul><ul><ul><ul><li>Children who successfully complete this stage feel secure and confident, while those who do not are left with a sense of inadequacy and self-doubt </li></ul></ul></ul>
    23. 23. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Psychosocial Development <ul><ul><li>Autonomy vs. Shame & Doubt </li></ul></ul><ul><ul><ul><li>Inability to control one’s body functions </li></ul></ul></ul><ul><ul><ul><li>Inability to gain control over food choices, toy preferences, and clothing selection (neglectful, controlling families; institutional settings) </li></ul></ul></ul>
    24. 24. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Psychosocial Development <ul><ul><li>Initiative vs. Guilt </li></ul></ul><ul><ul><ul><li>During the preschool years, children begin to assert their power and control over the world through directing play and other social interaction. </li></ul></ul></ul><ul><ul><ul><li>Children who are successful at this stage feel capable and able to lead others. </li></ul></ul></ul><ul><ul><ul><li>Those who fail to acquire these skills are left with a sense of guilt, self-doubt and lack of initiative </li></ul></ul></ul>
    25. 25. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Psychosocial Development <ul><ul><li>Initiative vs. Guilt </li></ul></ul><ul><ul><ul><li>Few friendships/peer relationships </li></ul></ul></ul><ul><ul><ul><li>Friendships in which individual had no control (bossed around, </li></ul></ul></ul><ul><ul><ul><li>bullied) </li></ul></ul></ul>
    26. 26. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Psychosocial Development <ul><ul><li>Industry vs. Inferiority </li></ul></ul><ul><ul><ul><li>Through social interactions, children begin to develop a sense of pride in their accomplishments and abilities. </li></ul></ul></ul><ul><ul><ul><li>Children who are encouraged and commended by parents and teachers develop a feeling of competence and belief in their skills. Those who receive little or no encouragement from parents, teachers, or peers will doubt their ability to be successful . </li></ul></ul></ul>
    27. 27. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Psychosocial Development <ul><ul><li>Industry vs. Inferiority </li></ul></ul><ul><ul><ul><li>Few friendships/peer relationships </li></ul></ul></ul><ul><ul><ul><li>Parents, family members, teachers, friends, or peers who never </li></ul></ul></ul><ul><ul><ul><li>encouraged them </li></ul></ul></ul><ul><ul><ul><ul><li>Called names (retard, moron, stupid, etc.) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Never given opportunity to shine </li></ul></ul></ul></ul>
    28. 28. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Psychosocial Development <ul><ul><li>Identity vs. Confusion </li></ul></ul><ul><ul><ul><li>Those who receive proper encouragement and reinforcement through personal exploration will emerge from this stage with a strong sense of self and a feeling of independence and control. </li></ul></ul></ul><ul><ul><ul><li>Those who remain unsure of their beliefs and desires will feel insecure and confused about themselves and the future. </li></ul></ul></ul>
    29. 29. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Psychosocial Development <ul><ul><li>Identity vs. Confusion </li></ul></ul><ul><ul><ul><li>Few friendships/peer relationships </li></ul></ul></ul><ul><ul><ul><li>Parents, family members, teachers, friends, or peers who never </li></ul></ul></ul><ul><ul><ul><li>encouraged them </li></ul></ul></ul><ul><ul><ul><li>Called names (retard, moron, stupid, etc.) </li></ul></ul></ul><ul><ul><ul><li>Never given opportunity to shine </li></ul></ul></ul>
    30. 30. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Psychosocial Development <ul><ul><li>Intimacy vs. Isolation </li></ul></ul><ul><ul><ul><li>Develop close, committed relationships with other people. Those who are successful at this step will develop relationships that are committed and secure. </li></ul></ul></ul><ul><ul><ul><li>Remember that each step builds on skills learned in previous steps. A strong sense of personal identity was important to developing intimate relationships. Studies have demonstrated that those with a poor sense of self tend to have less committed relationships and are more likely to suffer emotional isolation, loneliness, and depression . </li></ul></ul></ul>
    31. 31. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Psychosocial Development <ul><ul><li>Intimacy vs. Isolation </li></ul></ul><ul><ul><ul><li>Never developed close, committed relationships with other people – family, friends, peers </li></ul></ul></ul><ul><ul><ul><ul><li>Institutionalized at a young age </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Isolated from peers (stayed home, segregated) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Social disorders (Autism, anxiety, emotional/behavioral) </li></ul></ul></ul></ul>
    32. 32. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Conditioning <ul><ul><li>Abuse – physical, emotional, verbal, or sexual abuse </li></ul></ul><ul><ul><li>Neglect – lack of food, clothing, personal possessions, supervision </li></ul></ul><ul><ul><li>Attention – no positive attention provided, only negative attention </li></ul></ul><ul><ul><li>Modeling/Copying – behaviors they observed others display </li></ul></ul><ul><ul><li>Control – task avoidance, getting what they want </li></ul></ul><ul><ul><li>Bribery – given rewards to behave </li></ul></ul><ul><ul><li>Relieve Anxiety – vents inner turmoil </li></ul></ul>
    33. 33. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Conditioning <ul><ul><li>Abuse – physical, emotional, verbal, or sexual abuse </li></ul></ul><ul><ul><ul><li>hit/beaten by family, peers, strangers, staff </li></ul></ul></ul><ul><ul><ul><li>strapped down to chairs, beds, left in cars, locked in closets </li></ul></ul></ul><ul><ul><ul><li>given medicine to make them sleep or be compliant </li></ul></ul></ul><ul><ul><ul><li>yelled at, called names, told they were stupid, fat, ugly, etc. </li></ul></ul></ul><ul><ul><ul><li>sexually abused by family, peers, strangers, staff </li></ul></ul></ul>
    34. 34. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Conditioning <ul><ul><li>Neglect – lack of food, clothing, personal possessions </li></ul></ul><ul><ul><ul><li>poverty – little to no food available </li></ul></ul></ul><ul><ul><ul><li>theft – food, clothing, possessions stolen by siblings, housemates, </li></ul></ul></ul><ul><ul><ul><li>staff </li></ul></ul></ul><ul><ul><ul><li>lack of supervision – left to run wild, left alone, left in bathtub, </li></ul></ul></ul><ul><ul><ul><li>burned by hot water, bitten by animals, etc. </li></ul></ul></ul>
    35. 35. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Conditioning <ul><ul><li>Attention – no positive attention provided, only negative attention </li></ul></ul><ul><ul><ul><li>crying, yelling screaming (hungry baby) </li></ul></ul></ul><ul><ul><ul><li>swearing, calling offensive/racist names </li></ul></ul></ul><ul><ul><ul><li>fighting </li></ul></ul></ul><ul><ul><ul><li>property destruction </li></ul></ul></ul><ul><ul><ul><li>running away </li></ul></ul></ul><ul><ul><ul><li>self-abusive behavior </li></ul></ul></ul>
    36. 36. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Conditioning <ul><ul><li>Modeling/Copying – behaviors they observed others display </li></ul></ul><ul><ul><ul><li>fighting/abusing staff housemates </li></ul></ul></ul><ul><ul><ul><li>property destruction </li></ul></ul></ul><ul><ul><ul><li>offensive language, racism </li></ul></ul></ul><ul><ul><ul><li>sexually inappropriate language, touching </li></ul></ul></ul><ul><ul><ul><li>self abusive behavior </li></ul></ul></ul><ul><ul><ul><li>yelling, screaming, crying </li></ul></ul></ul>
    37. 37. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Conditioning <ul><ul><li>Control – task avoidance, getting what they want </li></ul></ul><ul><ul><ul><li>tantrums – property destruction, dropping to floor, screaming </li></ul></ul></ul><ul><ul><ul><li>offensive language – calling people names to hurt them </li></ul></ul></ul><ul><ul><ul><li>physical aggression – attacking staff, housemates, strangers </li></ul></ul></ul><ul><ul><ul><li>self-abuse – cutting, hitting, biting/scratching </li></ul></ul></ul><ul><ul><ul><li>splitting – she said no, but maybe he’ll say yes </li></ul></ul></ul><ul><ul><ul><ul><li>if it worked once, it will work again </li></ul></ul></ul></ul>
    38. 38. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Conditioning <ul><ul><li>Bribery – given rewards to behave </li></ul></ul><ul><ul><ul><li>food, eating out </li></ul></ul></ul><ul><ul><ul><li>community outings </li></ul></ul></ul><ul><ul><ul><li>tokens (gold stars, stickers, trinkets) </li></ul></ul></ul><ul><ul><ul><li>money </li></ul></ul></ul>
    39. 39. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? What factors contribute to people’s behaviors? Behavioral Psychology 101 Conditioning <ul><ul><li>Relieve Anxiety – vents inner turmoil </li></ul></ul><ul><ul><ul><li>tantrums – property destruction, dropping to floor, screaming </li></ul></ul></ul><ul><ul><ul><li>offensive language – calling people names to hurt them </li></ul></ul></ul><ul><ul><ul><li>physical aggression – attacking staff, housemates, strangers </li></ul></ul></ul><ul><ul><ul><li>self-abuse – cutting, hitting, biting/scratching </li></ul></ul></ul>
    40. 40. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Anyone who has ever made and broken a New Year’s Resolution can appreciate the difficulty of behavior change. Making a lasting change in behavior is rarely a simple process, and usually involves a substantial commitment of time, effort, and emotion. Whether we want to assist an individual with losing weight, stop smoking, or stop being physically aggressive, there is no single solution that works for everyone. We may have to try several different techniques, often through a process of trial-and-error, in order to help them achieve their goal. The key to achieving lasting behavioral change is to try new techniques and find ways to help the individual stay motivated. By combining our understanding of behavioral psychology with other proven psychological techniques, we can learn how to effectively assist individuals in changing a behavior. <ul><ul><li>Is it possible for people who behave one way </li></ul></ul><ul><ul><li>to learn to behave another way? </li></ul></ul>
    41. 41. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? Cross your arms on your chest. Now, uncross the arms and fold them again in the new way. Again. And again. OK, now unfold your arms and switch their positions so that the one that was on the bottom is now on the top (and vice versa). In fact, for the rest of your life, do it this new way. Don't ever make a mistake or revert to the old way. Think that'll be difficult? Yep. <ul><ul><li>Is it possible for people who behave one way </li></ul></ul><ul><ul><li>to learn to behave another way? </li></ul></ul>
    42. 42. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? <ul><ul><li>Is it possible for people who behave one way </li></ul></ul><ul><ul><li>to learn to behave another way? </li></ul></ul>Now imagine what we are asking our individuals to do. We expect them to immediately change a behavior that is indelibly etched into their brains and feels comfortable to them due to a lifetime of repetition and reinforcement. Individuals who display disruptive behaviors as they interact with others will have a long and arduous path to travel as they work to change to &quot;a better way.“ Thank goodness they have a patient and supportive teacher like you. You'll support them as they struggle to show the new behavior. You'll focus on progress rather than perfection, seeing evidence of the new rather than vestiges of the old.
    43. 43. Positive Behavioral Supports What Is The Goal Of Positive Behavioral Supports? <ul><ul><li>So, what is the goal of Positive Behavioral Supports? </li></ul></ul>The goal of Positive Behavioral Support (PBS) is: PBS is based on behavioral theory; problem behavior continues to occur because it is consistently followed by the individual getting something positive or escaping something negative . By focusing on the contexts and outcomes of the behavior, it is possible to determine the functions of the behavior, make the problem behavior less effective and efficient, and make the desired behavior (pro-social skills) more functional. This often involves changing systems, altering environments and teaching new skills, as well as focusing on the problem behavior. to eliminate challenging behaviors and replace them with pro-social skills.
    44. 44. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? <ul><li>The most significant obstacles to providing PBS to our individuals: </li></ul><ul><li>Resistance by Individuals </li></ul><ul><li>Resistance by Staff </li></ul><ul><li>Inaccurate Support Plans </li></ul><ul><li>Lack of Consistency </li></ul><ul><li>Poor Team Communication </li></ul>
    45. 45. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Read, “Ron’s Story” <ul><li>What are Ron’s disruptive behaviors? </li></ul><ul><li>Name some of the issues which might be contributing to Ron’s </li></ul><ul><li>disruptive behaviors – cognitive, psychosocial, conditioned? </li></ul><ul><li>What challenges do you see in helping Ron develop more pro- </li></ul><ul><li>social skills? </li></ul>
    46. 46. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Resistance by Individuals <ul><li>Does the individual want to change? </li></ul><ul><ul><li>Many of our individuals are not aware their behavior is “a problem” </li></ul></ul><ul><ul><ul><li>cognitive limitations – they don’t understand it’s a problem </li></ul></ul></ul><ul><ul><ul><li>it’s not a problem if it works – they get what they want, or avoid what </li></ul></ul></ul><ul><ul><ul><li>they don’t want </li></ul></ul></ul><ul><ul><li>Even if they are aware their behavior is a problem, are they even </li></ul></ul><ul><ul><li>interested in putting in the hard work it will take to let go of the problem </li></ul></ul><ul><ul><li>behavior and learning a new pro-social skill </li></ul></ul>
    47. 47. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Resistance by Individuals <ul><li>Is the individual capable of change? </li></ul><ul><ul><li>Cognitive Limitations – individuals with developmental disabilities are </li></ul></ul><ul><ul><li>not always capable of changing their behavior due to </li></ul></ul><ul><ul><ul><li>impaired brain function - for example, </li></ul></ul></ul><ul><ul><ul><ul><li>Traumatic Brain Injury – individuals with TBI have impaired </li></ul></ul></ul></ul><ul><ul><ul><ul><li>brain function due to their injury, particularly in areas of short </li></ul></ul></ul></ul><ul><ul><ul><ul><li>term memory and impulse control </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Mental Retardation – individuals with MR have impaired brain </li></ul></ul></ul></ul><ul><ul><ul><ul><li>function due to sections of their brain not being fully developed </li></ul></ul></ul></ul><ul><ul><ul><ul><li>which may affect their impulse control or ability to understand </li></ul></ul></ul></ul><ul><ul><ul><ul><li>the concepts behind new pro-social behaviors </li></ul></ul></ul></ul><ul><ul><li>Mental Health – individuals may not be able to regulate their emotions </li></ul></ul><ul><ul><li>or think “clearly” under stress due to psychological diagnoses </li></ul></ul><ul><ul><li>(Depression, Bipolar, Anxiety, Schizophrenia, Psychotic) </li></ul></ul>
    48. 48. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Resistance by Individuals <ul><li>Difficulty of letting go of learned behaviors </li></ul><ul><ul><li>Teaching an Old Dog New Tricks – As previously discussed, learned behaviors may be very difficult to “unlearn” </li></ul></ul><ul><ul><ul><li>they are difficult enough to unlearn for individuals without impaired </li></ul></ul></ul><ul><ul><ul><li>cognitive functioning – even more so for individuals with DD </li></ul></ul></ul><ul><ul><li>Emotional Roots – if behavior is rooted in a negative emotional context, </li></ul></ul><ul><ul><li>particularly in early childhood, it will be even more difficult to unlearn </li></ul></ul><ul><ul><ul><li>behaviors connected to abuse, neglect, abandonment, etc. </li></ul></ul></ul><ul><ul><li>“ If it Ain’t Broke, Don’t Fix It” – the problem behaviors have worked for </li></ul></ul><ul><ul><li>many years and continue to work – why change </li></ul></ul><ul><ul><ul><li>“ When I scream, bite, and kick my parents give me the snack I want.” </li></ul></ul></ul><ul><ul><ul><li>“ When I soil myself, staff have to pay attention to me.” </li></ul></ul></ul>
    49. 49. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Resistance by Individuals <ul><li>Difficulty of internalizing new behaviors </li></ul><ul><ul><li>Consequence/Reward Mentality – many of our individuals have been </li></ul></ul><ul><ul><li>conditioned over the years to “be good” or “behave” </li></ul></ul><ul><ul><ul><li>consequences </li></ul></ul></ul><ul><ul><ul><ul><li>something taken away – personal item, food, recreation </li></ul></ul></ul></ul><ul><ul><ul><ul><li>threat of taking something away </li></ul></ul></ul></ul><ul><ul><ul><ul><li>isolated – time out, sent to room </li></ul></ul></ul></ul><ul><ul><ul><ul><li>physically restrained </li></ul></ul></ul></ul><ul><ul><ul><ul><li>abused – beaten, burned, shocked </li></ul></ul></ul></ul><ul><ul><ul><li>rewards </li></ul></ul></ul><ul><ul><ul><ul><li>food, television, computer/game time </li></ul></ul></ul></ul><ul><ul><ul><ul><li>token economies – “If you’re good you’ll get a token. If you get </li></ul></ul></ul></ul><ul><ul><ul><ul><li>five tokens, you can go to the movies Saturday night.” </li></ul></ul></ul></ul>
    50. 50. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Resistance by Individuals <ul><li>Difficulty of internalizing new behaviors </li></ul><ul><ul><li>While consequences and rewards can be used to stop disruptive </li></ul></ul><ul><ul><li>behaviors, they do nothing to promote or develop new pro-social </li></ul></ul><ul><ul><li>behaviors – you’re rewarding the absence of a disruptive behavior, not </li></ul></ul><ul><ul><li>the presence of a pro-social behavior </li></ul></ul><ul><ul><li>If the reward or consequence is removed, will the disruptive behavior </li></ul></ul><ul><ul><li>return? </li></ul></ul><ul><ul><li>Internalization – in order for an individual to truly change their behavior, </li></ul></ul><ul><ul><li>they must internalize it and make it their own. Many of our individuals are </li></ul></ul><ul><ul><li>not capable of or have an extremely difficult time taking this step due to </li></ul></ul><ul><ul><li>their cognitive limitations </li></ul></ul>
    51. 51. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Resistance by Staff <ul><li>Personal Reasons </li></ul><ul><ul><li>Personality </li></ul></ul><ul><ul><ul><li>unable to see the individual, only see the behavior – “no hope” </li></ul></ul></ul><ul><ul><ul><li>negative attitude – unable to compliment, praise, or encourage </li></ul></ul></ul><ul><ul><ul><li>lack of patience with disruptive behaviors </li></ul></ul></ul><ul><ul><ul><li>stress – poor sleep habits, financial, relationships </li></ul></ul></ul><ul><ul><ul><li>afraid of individuals and/or disruptive behaviors </li></ul></ul></ul><ul><ul><ul><li>difficulty thinking clearly during a crisis </li></ul></ul></ul><ul><ul><li>Lack of Interest </li></ul></ul><ul><ul><ul><li>just in it for the paycheck </li></ul></ul></ul><ul><ul><ul><li>burned out </li></ul></ul></ul><ul><ul><ul><li>disagree with PBS or Gentle Teaching approach </li></ul></ul></ul>
    52. 52. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Resistance by Staff <ul><li>Performance Reasons </li></ul><ul><ul><li>Difficulty </li></ul></ul><ul><ul><ul><li>behaviors are perceived as “too difficult to deal with” </li></ul></ul></ul><ul><ul><ul><li>it would be easier/faster to reward or punish than to plan, praise, & </li></ul></ul></ul><ul><ul><ul><li>redirect </li></ul></ul></ul><ul><ul><li>Personal Parenting-Style </li></ul></ul><ul><ul><ul><li>can’t let go of techniques they use with their own kids </li></ul></ul></ul><ul><ul><li>Poor Preparation </li></ul></ul><ul><ul><ul><li>don’t mentally prepare themselves to be in PBS-mode each day </li></ul></ul></ul>
    53. 53. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Resistance by Staff <ul><li>Lack of Support </li></ul><ul><ul><li>Poor Support Plan </li></ul></ul><ul><ul><ul><li>the plan is not accurate or effective </li></ul></ul></ul><ul><ul><ul><li>intervention techniques don’t work </li></ul></ul></ul><ul><ul><li>Poor Training </li></ul></ul><ul><ul><ul><li>don’t feel they know what they’re doing </li></ul></ul></ul><ul><ul><li>Poor Communication </li></ul></ul><ul><ul><ul><li>supervisor doesn’t provide resources (schedules, petty cash) </li></ul></ul></ul><ul><ul><ul><li>feel their feedback is not respected or simply ignored </li></ul></ul></ul><ul><ul><ul><li>Behavior Specialist never meets with them </li></ul></ul></ul>
    54. 54. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Inaccurate Support Plan <ul><li>The two most crucial components of developing an effective Positive </li></ul><ul><li>Behavioral Support Plans are: </li></ul><ul><ul><li>Functional Behavioral Assessment – which provides accurate information about the individual’s cognitive limitations including IQ, developmental and psychological diagnoses, etc. </li></ul></ul><ul><ul><li>Accurate Psychosocial History – describing the individual’s social history including their family relationship history, school and peer history, residential living history (institutions, group homes, etc.), and behavioral history including antecedents, consequences, and frequency of challenging behavior. </li></ul></ul><ul><li>If either of these are absent or inaccurate, the plan will be inaccurate and significantly less effective. </li></ul>
    55. 55. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Inaccurate Support Plan <ul><li>Absence of Replacement/Pro-Social Behaviors </li></ul><ul><ul><li>Identifying new replacement behaviors and skills to teach as an </li></ul></ul><ul><ul><li>alternative to the challenging behavior is one of the most important </li></ul></ul><ul><ul><li>aspects of Positive Behavior Support. When you observe and </li></ul></ul><ul><ul><li>understand why a challenging behavior is happening, you should </li></ul></ul><ul><ul><li>identify the new skill or behavior you want the person to do instead. </li></ul></ul><ul><ul><li>If you don’t identify replacement behaviors, how will the individual know </li></ul></ul><ul><ul><li>what he/she should do instead of the challenging behavior? </li></ul></ul><ul><ul><ul><li>“ Okay. I shouldn’t punch a hole in the wall when I’m angry. What </li></ul></ul></ul><ul><ul><ul><li>should I do instead?” </li></ul></ul></ul>
    56. 56. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Inaccurate Support Plan <ul><li>Replacement/Pro-Social Behaviors </li></ul><ul><ul><li>The four general guidelines for successfully teaching replacement behaviors are: </li></ul></ul><ul><ul><li>The replacement behavior must serve the same purpose as the challenging behavior. </li></ul></ul><ul><ul><li>The replacement behavior must receive payoff/reinforcement as soon or sooner than the challenging behavior. </li></ul></ul><ul><ul><li>The replacement behavior must get as much or more payoff/reinforcement than the original challenging behavior. </li></ul></ul><ul><ul><li>The replacement behavior must be just as easy or easier to do than the challenging behavior </li></ul></ul>
    57. 57. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Inaccurate Support Plan <ul><li>Ineffective Replacement/Pro-Social Behaviors </li></ul><ul><ul><li>Obviously, if the replacement behaviors aren’t </li></ul></ul><ul><ul><li>serving the same purpose as the challenging behavior. </li></ul></ul><ul><ul><li>providing payoff/reinforcement as soon or sooner than the challenging behavior. </li></ul></ul><ul><ul><li>providing as much or more payoff/reinforcement than the original challenging behavior. </li></ul></ul><ul><ul><li>just as easy or easier to do than the challenging behavior </li></ul></ul><ul><li>The individual will never internalize the replacement/pro-social behavior(s) </li></ul>
    58. 58. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Lack of Consistency <ul><ul><li>In order for replacement behaviors to “take hold,” all of the care givers in </li></ul></ul><ul><ul><li>the individual’s life must be on the same page – direct care staff, </li></ul></ul><ul><ul><li>supervisors, teachers, day service staff and supervisors, job coaches, </li></ul></ul><ul><ul><li>employers, family members and friends. </li></ul></ul><ul><ul><li>Like water, human beings seek the “path of least resistance.” </li></ul></ul><ul><ul><li>Remember our discussion of how hard it is to change our behavior? </li></ul></ul><ul><ul><li>Individuals will generally seek the path of least resistance as we attempt </li></ul></ul><ul><ul><li>to help them develop their pro-social skills. </li></ul></ul><ul><ul><li>In this metaphor, the path of least resistance are those care givers who </li></ul></ul><ul><ul><li>reinforce the individual’s challenging behaviors by “giving in” rather than </li></ul></ul><ul><ul><li>putting in the hard work of using the interventions outlined in the </li></ul></ul><ul><ul><li>individual’s PBS plan. </li></ul></ul>
    59. 59. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Lack of Consistency <ul><li>When working in residential, day service, employment, and in-home </li></ul><ul><li>support settings, you will likely experience some, if not all, of the </li></ul><ul><li>following examples of inconsistency in implementing an individual’s PBS </li></ul><ul><li>plan: </li></ul><ul><ul><li>Staff-to-Staff – one staff on duty is the good cop, one the bad cop </li></ul></ul><ul><ul><li>Shift-to-Shift – one shift sticks with the plan, another shift doesn’t </li></ul></ul><ul><ul><li>Supervisor-Staff – staff try to implement the plan, but the manager </li></ul></ul><ul><ul><li>is a “softy” (or vice-versa) </li></ul></ul><ul><ul><li>Residential – School/Day/Work – residential staff try to implement </li></ul></ul><ul><ul><li>the plan, but the school/day/work staff are “softies” (or vice-versa) </li></ul></ul><ul><ul><li>Provider – Family - provider staff try to implement the plan, but the </li></ul></ul><ul><ul><li>family does things their own way (or vice-versa) </li></ul></ul>
    60. 60. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Poor Team Communication The single most helpful strategy to use in developing an accurate and effective PBS plan is to communicate openly with fellow team members regarding the ongoing effectiveness of the plan. As you would expect, the single most damaging obstacle to developing an accurate and effective PBS plan is poor team communication regarding the ongoing implementation of the plan. The following are considered to be forms of team communication: <ul><li>Feedback (Staff & Individual) </li></ul><ul><li>Documentation </li></ul><ul><li>Agency/Family Communication </li></ul><ul><li>Shift-to-Shift Communication </li></ul><ul><li>Staff-Manager Communication </li></ul><ul><li>Behavior Specialist Communication </li></ul>
    61. 61. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Poor Team Communication <ul><li>Staff Feedback – on the effectiveness, or lack thereof, of interventions, </li></ul><ul><li>progress on developing pro-social behaviors, implementation of PBS </li></ul><ul><li>interventions. You are the frontline </li></ul><ul><li>Documentation – recording behavior data, recording ABC/Maintaining </li></ul><ul><li>Composure Data, completing positive behavior data sheets, emailing data </li></ul><ul><li>to behavior specialist </li></ul><ul><li>Res/Day/Family Communication – advanced planning, communication of challenging behaviors “as they happen” </li></ul>
    62. 62. Positive Behavioral Supports What Are The Challenges of Positive Behavioral Supports? Poor Team Communication <ul><li>Shift-to-Shift Communication – were any challenging behaviors displayed on shift, what were antecedents leading to behavior, what pro-social behaviors were displayed on shift? </li></ul><ul><li>Staff-Manager Communication – same as above </li></ul><ul><li>Behavior Specialist – updated interventions and/or replacement behaviors </li></ul>
    63. 63. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 1 -> Develop Accurate & Effective PBS Plan <ul><li>Psychological & Psychosocial Assessments </li></ul><ul><li>Identify Challenging Behaviors </li></ul><ul><li>Identify Reinforcement(s) for Each Challenging Behavior </li></ul><ul><li>Identify Replacement/Pro-Social Skills to Replace Challenging Behaviors </li></ul><ul><li>Develop Intervention Approaches & Strategies for Staff </li></ul>
    64. 64. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 2 -> Train Staff on Plan <ul><li>Learn Concepts & Terminology </li></ul><ul><ul><li>Antecedent – what was happening immediately before the individuals began the challenging behavior? </li></ul></ul><ul><ul><ul><li>Information may help us identify why the individual engages in this challenging behavior </li></ul></ul></ul><ul><ul><ul><li>Anxiety, task avoidance, indication of pain, attention </li></ul></ul></ul><ul><ul><li>Topography – what does the behavior look like, what took place? </li></ul></ul><ul><ul><li>Maintaining Variables – why does the behavior continue, what does the individual “get out” of it, what’s the “payoff?” </li></ul></ul><ul><ul><li>Reinforcement – what is the function of the behavior, how does the behavior make the individual feel better? </li></ul></ul>
    65. 65. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 2 -> Train Staff on Plan <ul><li>Learn Concepts & Terminology </li></ul><ul><ul><li>Replacement/Pro-Social Behaviors – what behaviors are we helping the individual learn to display instead of their challenging behaviors? </li></ul></ul><ul><ul><li>Proactive Intervention – staff actions designed to help the individual avoid engaging in challenging behaviors, or which may keep a challenging behavior from escalating </li></ul></ul><ul><ul><ul><li>interaction style – tone of voice, asking questions rather than giving commands, humor, redirection, validate feelings </li></ul></ul></ul><ul><ul><ul><li>environmental – daily schedule, visual aids, engage in meaningful activities </li></ul></ul></ul>
    66. 66. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 2 -> Train Staff on Plan <ul><li>Learn Concepts & Terminology </li></ul><ul><ul><li>Reactive Intervention – staff actions after an individual is engaging in challenging behaviors which may help to </li></ul></ul><ul><ul><ul><li>redirect the individual away from challenging behavior </li></ul></ul></ul><ul><ul><ul><li>reduce the intensity or duration of the challenging behavior </li></ul></ul></ul><ul><ul><ul><li>prevent injury/harm to the individual, staff, or others </li></ul></ul></ul><ul><ul><li>Premack Principle (Critical Scheduling) – scheduling preferred and non-preferred activities together to increase individual’s interest in participating in non-preferred activities – “ Why don’t you take a shower and then we’ll play the Wii together ?” </li></ul></ul><ul><ul><li>Verbal Redirection – talking with the individual as they begin, or as they are engaged in challenging behaviors to divert their attention </li></ul></ul>
    67. 67. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 2 -> Train Staff on Plan <ul><li>Understand the Purpose of the Plan </li></ul><ul><ul><li>What the plan is NOT : </li></ul></ul><ul><ul><ul><li>Punishment – other than natural consequences, we don’t </li></ul></ul></ul><ul><ul><ul><ul><li>punish individuals (time outs, go to bed, ignore them, etc.) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>take away rights, privileges, or possessions </li></ul></ul></ul></ul><ul><ul><ul><ul><li>make them feel guilty (forced apologies, you’re bad, what would your mom think?) </li></ul></ul></ul></ul><ul><ul><ul><li>Behavior Management – we’re not looking to change their behavior, cure them, or fix them </li></ul></ul></ul>
    68. 68. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 2 -> Train Staff on Plan <ul><li>Understand the Purpose of the Plan </li></ul><ul><ul><li>What the plan IS : </li></ul></ul><ul><ul><ul><li>Pro-Social Skill Development – we’re looking to </li></ul></ul></ul><ul><ul><ul><ul><li>Increase emotion regulation </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Learn distress tolerance and coping skills (e.g., self-soothing). </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Identify and express emotions appropriately. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Becoming more self-reliant and independent </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Maintaining safe behavior by making good decisions and using good judgment. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Learning to cope with disappointment and conflict. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Increase self-esteem and develop a positive self-concept. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Increase interpersonal effectiveness and social skills </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Participate more fully in community activities </li></ul></ul></ul></ul>
    69. 69. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 3 -> Implement the Plan <ul><li>Be Proactive – “measure twice, cut once” </li></ul><ul><ul><li>Be Prepared </li></ul></ul><ul><ul><ul><li>familiarize yourself thoroughly with the individual’s plan, the desired pro-social behaviors, pro-social language, and intervention strategies </li></ul></ul></ul><ul><ul><li>Plan Ahead </li></ul></ul><ul><ul><ul><li>set the individual up to succeed rather than fail </li></ul></ul></ul><ul><ul><ul><li>use choice making, give individual advanced notice </li></ul></ul></ul><ul><ul><li>Know & Avoid Triggers </li></ul></ul><ul><ul><ul><li>if you know the individual will become agitated if they don’t get seconds at dinner, give them half their portion as their first serving and the other half as their second serving </li></ul></ul></ul>
    70. 70. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 3 -> Implement the Plan <ul><li>Be Consistent – “we’re only as strong as our weakest link” </li></ul><ul><ul><li>All Staff (including managers and administrative staff) </li></ul></ul><ul><ul><li>All Shifts </li></ul></ul><ul><ul><li>School/Work </li></ul></ul><ul><ul><li>Family Home </li></ul></ul><ul><li>Lack of consistency leads to: </li></ul><ul><ul><li>reinforcement of challenging behaviors (still getting the payoff) </li></ul></ul><ul><ul><li>slower development of pro-social skills </li></ul></ul><ul><ul><li>some caregivers being seen as the “bad guy” by the individual (splitting) </li></ul></ul>
    71. 71. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 3 -> Implement the Plan <ul><li>Be Compassionate – “people only care how much you know when they know how much you care” </li></ul><ul><ul><li>Gentle Teaching – “safe, loved, loving, & engaged” </li></ul></ul><ul><ul><li>Active Listening – listen with your eyes, ears, and presence </li></ul></ul><ul><ul><li>Validation – “I hear that you’re angry” </li></ul></ul><ul><ul><li>Positive Attribution – praise each time you observe see the individual display a pro-social skill </li></ul></ul><ul><ul><li>Role Model – practice what you preach: display pro-social skills with the individual, your coworkers, visitors, in the community, and on the phone </li></ul></ul>
    72. 72. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 3 -> Implement the Plan <ul><li>Communicate – </li></ul><ul><ul><li>Documentation </li></ul></ul><ul><ul><ul><li>Behavior Data Charts </li></ul></ul></ul><ul><ul><ul><li>Behavioral Worksheets </li></ul></ul></ul><ul><ul><ul><li>ABC/Maintaining Composure Sheets </li></ul></ul></ul><ul><ul><ul><li>Health & Safety Data Sheets </li></ul></ul></ul><ul><ul><ul><li>Daily Logs, Vocational Logs </li></ul></ul></ul><ul><ul><ul><li>Communication Logs (Shift-to-Shift, Staff-to-Supervisor, Residence-to-School/Day, Residence-to-Family) </li></ul></ul></ul><ul><ul><ul><li>DDS 255 Incident Reports </li></ul></ul></ul>
    73. 73. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 3 -> Implement the Plan <ul><li>Communicate – </li></ul><ul><ul><li>Documentation </li></ul></ul><ul><ul><ul><li>Behavior Data Charts </li></ul></ul></ul>4 3 2 III 1 Verbal Threats Sleep Problem Running Away Skin Picking Food Stealing Property Destruct Agitation Self- Injury Physical Aggress Activity Refusal
    74. 74. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 3 -> Implement the Plan <ul><li>Communicate – </li></ul><ul><ul><li>Documentation </li></ul></ul><ul><ul><ul><li>ABC/Maintaining Composure Sheets </li></ul></ul></ul>JM Housemate became upset when food stolen Moved JC to opposite end of table Food Stealing Eating dinner with housemate Upset, fixated on dinner 5 min. 1 Staff Initials Comments Occurrences Behavior of Concern Antecedent/Precursor Behavior General Mood Duration of Episode Date/Time
    75. 75. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 3 -> Implement the Plan <ul><li>Communicate – </li></ul><ul><ul><li>Documentation </li></ul></ul><ul><ul><ul><li>Health & Safety Data Sheets – sleep data, food diary </li></ul></ul></ul>2 A S S A A S S S A 1 5a – 6a 4a – 5a 3a – 4a 2a – 3a 1a – 2a 12a – 1a 11p – 12a 10p – 11p 9p – 10p
    76. 76. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 3 -> Implement the Plan <ul><li>Communicate – </li></ul><ul><ul><li>Documentation </li></ul></ul><ul><ul><ul><li>Daily Logs, Vocational Logs </li></ul></ul></ul>
    77. 77. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 3 -> Implement the Plan <ul><li>Communicate – </li></ul><ul><ul><li>Documentation </li></ul></ul><ul><ul><ul><li>DDS 255 Incident Reports </li></ul></ul></ul>□ BEH avior other: ____________________________________ □ POL ice no-arrest □ FIR e Emergency Response □ W rong F ood C onsistency □ V ictim A ggravated A ssault □ P olice Ar rest □ AW o L / Missing Person □ V ictim S e X ual other □ S elf EN dangering/sib □ PIC a □ A ggressor S e X ual alleged □ V ictim T heft / L arceny □ R e F used M edication □ medical ER N o admit □ A ggressor PH ysical alleged □ V ictim PH ysical other □ PS ych ER N o admit □ medical ER A dmit □ accident VEH icle no apparent injury □ V ictim F orcible R ape □ PS ych ER A dmit □ Fi re N o Emg Response □ ACC ident no apparent injury Type: Time:_______:_______ A m P m - All dangerous / life threatening, illegal, police/fire, significant first/rare. Also ‘significant behavior not covered by program/guideline’ 2b – UNUSUAL
    78. 78. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 3 -> Implement the Plan <ul><li>Communicate – </li></ul><ul><ul><li>PBS Plan Feedback </li></ul></ul><ul><ul><ul><li>As the front-line, behavioral support specialist, you see and hear what no one else sees or hears. You have incredibly valuable information that the “professional plan developers” don’t have but need desperately </li></ul></ul></ul><ul><ul><ul><li>Verbally communicate what’s working and what’s not working to your supervisor – our goal is to develop the most accurate and effective PBS plan </li></ul></ul></ul><ul><ul><ul><li>Detail – provide as much detail as possible when documenting behavior to provide the most accurate information about antecedents, behavioral intensity, etc. </li></ul></ul></ul>
    79. 79. Positive Behavioral Supports How Do We Help Individuals Who Display Disruptive Behaviors? STEP 4 -> Additional Behavioral Supports <ul><li>Medications – as a part of individual’s psychiatric treatment plan to address issues of mood stability, anxiety, depression, etc. </li></ul><ul><li>DDS Program Review Committee (PRC) – reviews and approves medication treatment plans and behavior support plans </li></ul><ul><li>DDS Human Rights Committee (HRC) – reviews and approves restrictive measures sought to address behaviors which risk an individual’s health & safety </li></ul><ul><li>Restrictive Measures – door alarms, locked sharps/cleaning supplies, search protocols, transportation harnesses/seat belt clips, etc. </li></ul><ul><li>Behavioral “Emergency Techniques” (Crisis Management) – physical restraint techniques to prevent individuals from harming themselves or others </li></ul>

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