2. Sarah
9 year old female
No history of developmental delays
Evaluated for
medical/mental/psychological causes for
toe-walking
Diagnosed with idiopathic toe-walking
and shortened Achilles Tendon at age 7
Treatments: physical therapy (ongoing);
serial casting (12 weeks); Night splints
(ongoing); surgery in future?
3. Behavior
Target Behavior: avoidance behaviors
when asked to do exercises (through
stalling, fidgeting, doing out of sight)
Replacement Behavior: complete
exercises as shown by physical therapist in
a timely manner
4. FBA: Phase I
Team: Mom, Dad, Physical Therapist
Interviewed student, parents, therapist
Direct Observation (ABC Data)
Function Matrix
Positive
Reinforcement
Negative
Reinforcement
Attention
Tangibles/Activit
y X
Sensory X
5. Phase II: Intervention and
Testing
Method 2: Adjust Antecedent Conditions:
Set up scheduled time with student to
complete stretches
3 times daily (before breakfast, afterschool,
and at bedtime)
Reminders from Mom or Dad
10. Conclusions
Adjusting the antecedent was the key to
changing behavior
Praise and pointing out achieved skills also
showed importance of therapy and
exercises and seemed to make a
difference
Identifying sensory function also helped;
looked at additional sensory inputs and
explained to student
Currently implementation phase; fading
using self-monitoring, checklist, and timer
