1. POSITIVE
MANAGEMENT FOR
CHALLENGING
BEHAVIORS
IN CHILDREN WITH SPECIAL NEEDS
Stacy Carmichael, PhD ABPP
Licensed Psychologist
Board Certified, Clinical Child &
Adolescent Psychology

2. -Walter Barbee
If you’ve told a child a thousand times, and he still does not
understand, then it is not that child who is the slow learner.

3. What is behavior
management?
Behavior
management
is not an
attitude
adjustment
Systematic method of increasing or
decreasing behaviors
Teaching appropriate behaviors and
coping skills (discipline means “to
teach”)
What are behaviors? You can see them,
hear them and measure them if needed

4. Children with special needs at increased risk of
inappropriate behaviors because:
 They are not at the developmental level of same age
peers or siblings
 Adults or children may not know what to expect
 Motor planning difficulties, sensory concerns
 Cognitive delay, processing delay
 Difficult understanding abstract concepts such as
time, waiting
 Difficulty expressing wants, needs, feelings
 Anxiety
 Not understanding the perspectives and motives of
others
 As parents we may feel guilty and over-protect

5. Prioritizing behaviors to address
 How harmful is this behavior to your child or
other children/adults?
 How does this behavior interfere with your
child’s development and learning?
 How does this behavior interfere with your
child’s participation in family or peer activities?
 How does this behavior interfere with positive
social relationships/acceptance?

6. Common challenging behaviors
 Wandering
 Biting/hiting/kicking/throwing (aggression)
 Yelling/screaming/tantrums
 Non-compliance with requests
 Attentional concerns
 Lack of initiative/difficulty organizing behavior
 Toileting
 Sleeping
 Eating
 Playing/social skills

7. We teach….
If a child does not know how to read, we teach.
If a child does not know how to swim, we
teach.
If a child does not know how to multiply, we
teach.
If a child does not know how to drive, we
teach.
If a child does not know how to
behavior….we……..teach? ……..punish?

8. Punishment vs
reinforcement…what is going on?
 Operant conditioning (BF Skinner)
 Reinforce- to strengthen the probability of the
behavior
 Punish- to decrease the probability of behavior
POSITIVE STIMULUS NEGATIVE STIMULUS
PRESENTED Positive Reinforcement
(winning lottery)
Positive
Punishment
(speeding ticket, yelling,
spanking)
TAKEN AWAY Negative
Punishment
(Taking away cell phone
when teen breaks
curfew)
Negative Reinforcement
(putting anti-itch ointment
on bug bite)

10. Universal Preventative
Practices
 Review routines
 IF-THEN/earning
 Routines are clear, consistent (calendars, visual
schedules, visual timers for transitions)
 Review Physical Arrangements (tv, computer,
homework area, calm-down area, etc)
 Define and teach expectations and skills
 Positive house rules (use respectful language, pick up after
yourself, put toys away before you get new toys…..respect
others, yourself and property)
 Plan systematic responses
 To appropriate behaviors
 To inappropriate/challenging behaviors

11. What kind of “boss” are you?
Worst Supervisor Best Supervisor

12. What kind of “boss” are you?
 Makes
unreasonable
demands for my
level
 Keeps changing his
mind
 Has unclear
expectations
 Never says Thanks
or Good job
 Keeps things fair
 Sticks to the plan and
keeps me informed
 Rewards all
successes, big and
small
 Shows respect and
compassion
 Takes responsibility
as the boss
Worst Supervisor Best Supervisor

13. Special time
Improves the positivity of the parent-child
relationship
15 minutes daily, child directed interaction with a
specific skill-building activity
No questions, no criticisms, no commands
P –praise, labeled
R –reflect important comments from your child
I -imitate what you child is doing that you like
D –describe what your child is doing (sports
announcer)
E –be enthusiastic!

14. Increasing appropriate behavior:
Attention, Praise and Rewards
 CATCH KIDS BEING GOOD!
 ROUTINES
 VISUAL CUES/SUPPORTS TO KNOW WHAT TO EXPECT AND DO
 Positive attention
 Make positive attention specific
 Give positive attention right away
 Use powerful rewards that are not usually accessed
 Avoid criticism
 Tell your child WHAT TO DO, not what NOT to do
 (Bottom on the seat please. Hands to your sides.)
 May use visual aides, photos or video models. TELL-SHOW-DO
 Carry out promises, so make a request only if you have time to wait and
follow through
 Praise frequently
 Set them up for success with tasks you know they can do.
 Plan ahead to eliminate or decrease triggers (hunger, fatigue, crowds)

16. Ex: behaviors to praise
 Sharing toys
 Talking quietly
 Asking for help
 Nice manners
 Being flexible
 Being patient
 Expressing feelings
 Not interrupting
 Waking up on time
 Getting dressed on time
 Being creative
 Calming down when upset
 Walking softly
 Starting homework
 Making bed
 Putting away clothes
 Encouraging others
 Using humor
 Apologizing
 Being friendly
 Brushing teeth or hair
 Starting a new hobby
 Helping parent
 Picking up after self
 Telling the trying
 Complying with a time limit

17. Can you praise too much?
 Great expectations trap? Possible…
 Don’t praise indiscriminately, talk about specific
facts
 Focus on the EFFORT not the results, again
encourage
 Teach your child that it’s okay to make
mistakes, not be perfect, that is part of learning

18. Rewards
Types of rewards
 Verbal or social rewards (praise, hugs, high fives, games)
 Physical/non-social rewards (snacks, staying up or
preferred food, tokens or points to redeem for desired
object)
 Activity/sensory rewards (access to games, tv time, ipad
time, music, blowing bubbles)
For Effective rewards:
 Use rewards immediately
 Initially reward the behavior every time it occurs
 Reward only the behaviors you want to increase
 Billy, I liked the way you picked up your toys the first time I
asked! That makes mommy really happy.

19. Time-In
 Positive interactions and feedback children receive
when engaging in appropriate behavior
 Critical to quality of parent-child relationship
 CATCH THEM BEING GOOD!
 Doesn’t have to be a special occasion.
 Be specific, label your praise.
 Provide physical attention.
 Give immediate feedback.
 Avoid back-handed compliments.
 Use third-handed compliments.
 Plan parent-child activities that set them up for time-in.

20. Uh-oh, now what?
 Ignore the behavior (extinction) if it is mild and
only used to gain attention (planned ignoring)
 Redirection to another activity or appropriate
behavior is often helpful, provide choices
 Removal from a situation or reinforcement
(time-out)
 Try not to feed into the behavior to give
him/her what she wants, lecture/threaten,
show anger or disappointment, be physical

21. Time out
 Only helpful if “time-in” encourages appropriate
behaviors and allows access to desired reinforcers
(attention, toys.) Thus, it is actually “time-out” from
positive reinforcement (no talking to, warnings, looking
at, or access to reinforcers or escape from tasks.)
 Lead child away to time-out area, tell them why and
how long they will be in time-out.
 Use visual timer, no more than 5 minutes, about one
minute for every year of cognitive age.
 Immediately after, remind them why they went to time-
out, review how to handle the situation in the future,
and immediately begin time-in and provide positive
reinforcement for appropriate behaviors.
More at the Center for Effective Parenting, Parenting-ed.org

22. Ideas for decreasing challenging
behavior
 First try to increase appropriate behaviors so
that it provides the functional equivalent for the
child. Avoid giving attention to child during
problem behavior.
 During problem behavior, don’t escalate,
simply remind child about what they can DO
rather than NOT DO (“You could use your
words to ask your sister to share.”)
 After the problem behavior, provide immediate
praise for appropriate behaviors.

23. Research on PBS
 Effective for all ages of individuals with
disabities ages 2-50 years
 Effective for diverse groups of individuals with
challenges: intellectual disability, oppositional
behaviors, autism, emotional concerns etc
 PBS so far is the only comprehensive and
evidence based approach to address problem
behaviors within a variety of natural settings.

24. Positive Behavior Support
 General intervention for
all behavior problems
 Intervention is reactive
(decreased outside
activity, restraint,
spanking)
 Focus on behavior
reduction
 Quick fix
 Only the family involved
 Intervention matched to
purpose of behavior
 Intervention is
proactive
 Focus on teaching
new skills
 Long term interventions
 Involves family,
teachers, therapists,
admins, etc.
Old Way New Way

25. Positive Behavior Support Plans
 Simply “TOOLS to help children be more successful in
participating and succeeding in everyday life.”
-A Parent
 Remove the triggers to prevent problems
 Be proactive-set them up for success
 Eliminate the reinforcement of inappropriate behavior
 Provide skill instruction to build appropriate behaviors
or communication and decrease need for child to
engage in challenging behavior
 Increase reinforcement of appropriate behaviors
decrease reinforcement of challenging behaviors

26. ABC’s of Behavior
 Antecedent (what happened BEFORE)
 Behavior (what do you need to change)
 Consequence (what happens after the
behavior)

27. Common triggers of
misbehavior
 Pain, illness
 GERD/Reflux
 GI concerns/constipation
 Thyroid concerns
 Vision/hearing concerns
 Sleeping difficulties (apnea)
 Emotional distress-anxiety, depression
 Hungry, tired

28. Example of a rapid Functional Behavior Analysis
Find at: http://csefel.uiuc.edu (Center on the Social and Emotional Foundations for Early
Learning)
ABC Chart –Why is this behavior working?
Antecedent Behavior Consequenc
e

29. What is the function of the behavior?
WHY is your
child
engaging in
the problem
behavior in
the first
place?
 Typically, a child’s behaviors occurs to:
 ESCAPE/AVOID demanding task,
person, situation
 OBTAIN ACCESS to desired reinforcer
(object, activity, feeling)
 GAIN ATTENTION (even negative) from
other people
 Other communication (pain? sensory
overload?)

30. Formal PBS Process
 1:Establish your team, identify goals
 2: Gather information (FBA)
 3: Develop hypothesis (best guess as to
function of problem behavior)
 4: Design behavior support plans
 5: Implement, monitor, evaluate outcomes and
refine your plan

31. Support Plan for Challenging
Behaviors
 Behavior Hypothesis –what is the function or
purpose of the behavior?
 Prevention Strategies- Ways to make events
and interactions that precede the problem
behavior easier for your child to manage
 Replacement Skills-skills to teach throughout
the day to replace the problem behavior
 Responses- what will adults do when the
problem behavior occurs

33. Function of tantrums?
Antecedents
(Triggers)
Behaviors Consequences
/Responses
Walking to car from
house
Walking to car from
public place
Demand is placed on
going to next activity
-tired/late afternoon
Tantrums-cries, yells,
screams, throws self
onto ground,
sometimes throws
objects
FUNCTION:
Avoid/prolong transition
Sometimes allowed to
continue what he was
doing a bit longer
Verbal coaxing
Physically helped after
a bit of his tantrum

34. Ex: Prevention, New Skills and New
Responses
Prevention New Skills New Responses
-Give him
predictability with
mini schedule
-Count down/visual
timer to give him
time to process and
prepare for
transition
-”Going Places”
social story
-Say, “I don’t want
to.”
-Follow schedule.
-Go places with
adult and stay
(successful
transition)
-Ask “Where are we
going?” with
prompting.
To Problem Behaviors
-Praise brother and parent
-Prompt to use his words
and give him words
-Give Choices (Would you
like to walk by yourself or
hold hands? Would you like
to take the red car or the
blue car?)
To New Skill
-Give him highly desired
items to help reinforce
successful transitions
(juice, car)
-Praise for successful
transitions

36. Obstacles to success
 Parental optimism/pessimism about the ability to
influence their child’s behavior at age 3 was the
most significant factor in predicting which
children with a developmental disability
continued to have behavior problems at age 6
 (Durand, 2001)

37. Examples of Pessimistic and Optimistic Self-Talk
 My child is disabled.
 Shopping with my child is a
nightmare.
 That won’t work with my
child.
 I tried that and it didn’t
work!
 Oh no, here we go again.
 She has enough to deal
with. I’m not going to push.
 I’m not a good parent.
 My child needs help
learning new skills.
 My child is not yet ready
for shopping trips.
 I’ll try it.
 I’m willing to try it again.
 OK, I’m ready for this.
 She will learn how to
control herself.
 I work very hard at being
the best parent I can be.
Pessimistic Self-Talk Optimistic Self-Talk

38. More information:
 Fox and Duda, What Works Briefs: What are Children Trying to Tell Us?:
Assessing the Function of Their Behavior. Center on the Social and
Emotional Foundations for Early Learning.
 Clark, Lynn. (1996.) SOS! Help for Parents: A Practical Guide for Handling
Common Everyday Behavior Problems.
 Barkley and Benton. (1998.)Your Defiant Child. 8 Steps to Better Behavior.
 Van Bourgondien. (1993.) Bx Mgmt in the Early Years. Preschool Issues in
Autism.
 Website: Center for Effective Collaboration and Practice. http://cecp.air.org/
 Durand (2007.) Positive Family Intervention: Hope and Help for Parents
with Challenging Children. Psychology in Mental Retardation and
Developmental Disabilities, 32(3), 9-13.
 Rabiner, (2007.) Behavioral Treatment for ADHD: An Overview. Found at
www.helpforadd.com on 1/15/13/
 http://www.apbs.org/ Association for Positive Behavioral Supports