1. Preventing Problem Behavior of Young Children
Gregory P. Hanley. Ph.D., BCBA-D
Utah Neuropsychiatric Institute
Autism Intervention Program for Professionals
November, 2016

2. Some relevant correlations
Non-familial, center-based child care has been linked to problem behavior in young children (NICHD, 2003, 2006, 2011).
Some history:
It will not come as a surprise to many people in this room that problem behaviors such as aggression, disruptive behavior, and noncompliance in young children are associated with long-term social and academic difficulties.
There are numerous risk factors for developing problem behaviors that interfere with school success and necessitate costly support. Many are obvious, such as autism, developmental disability, extreme poverty, and having a single parent with a severe mental illness. Others are less obvious. In the last decade, non-maternal, center-based child care was linked to problem behavior in young children.
The National Institute of Child Health and Human Development Study of Early Child Care reported that time spent in non-maternal care across the first 4 1/2 years of life, was positively correlated with more adult reports of problems with aggression, disobedience, and assertiveness. The primary aim of our line of research is to identify and implement the non-maternal child care and classroom conditions that produce socially competent young children.

3. Some relevant correlations
Preschoolers are expelled from school at rates exceeding that of K-12 Students (Jacobson, 2005)
6.7 per 1000 for preschoolers
compared to
2.1 per 1000 for elem, middle, & high school students
The need to identify these conditions was made more important when Linda Jacobson of the Yale Child Study Center reported that preschool children are three times more likely to be expelled from school than K-12 students. This rate was even higher for preschoolers in center-based care.

4. What is the root of the problem
What is the root of the problem? Why aren’t children acquiring these functional (life) skills?
Strong emphasis on proactive approaches for dealing with problem behavior in preschools, e.g.:
multiple sets of the same play materials
carefully designed and predictable schedules
child-led free-play activities
frequent choice provision
high levels of noncontingent social praise
developmentally appropriate instruction
instruction embedded in play
incidental and errorless teaching
What is responsible for these relations between center-based care and preschooler problem behavior? No ones knows at this point; my hunch is based on the recommendations for addressing challenging behavior in preschools. Because problem behavior is often considered part of normal development, the emphasis is often placed on carefully designing the environment to minimize or altogether avoid problem behavior; here are some examples of proactive procedures in preschools. **
All of these strategies are employed prior to the occurrence of problem behavior, a proactive feature that was appealing to me and is appealing to early childhood teachers, presumably because problem behavior may be altogether avoided with successful implementation. The problem, however, is that by adopting these strategies, we avoid more than the problem behavior—we avoid opportunities to teach appropriate responses to challenging situations, we avoid strengthening important social repertoires.

5. What is the root of the problem
What is the root of the problem? Why aren’t children acquiring these functional (life) skills?
Situations that typically occasion problem behavior are actively eliminated or weakened
….and these are critical for teaching relevant social responses
Said another way, Typical teaching is actively eliminated or weakened and these are critical for teaching important social responses.
My hunch is that generally weak social skills repertoires and unchecked histories of effective problem behavior are contributing to this troublesome relationship between center-based care and preschooler problem behavior.

6. To prevent the development of problem behavior: Teach functional skills to produce the reinforcers that maintain problem behavior
Our research over the past decade has taught me that we need not get rid of the proactive strategies but we need to compliment them with another approach, and this approach involves teaching functional skills to prevent problem behavior from developing or reemerging
Let me be clear what I mean by a functional skill….

7. Prevention Model: A Start
Our first attempt towards developing a curriculum to prevent problem behavior was published in in 2007,

8. Prevention Model: A Start Hanley, Heal, Tiger, & Ingvarsson (JABA, 2007)
Repeatedly introduced challenging situations, and taught functionally equivalent skills prior to the development of severe problem behavior
(We call them Life Skills)
This was a preliminary evaluation of a class-wide teaching program for developing what we have come to call life skills. This is social skills training with a mission—that is to teach skills that may interfere with the development of problem behavior. In general, we do this not by avoiding challenging or what we call evocative situations that may bring about a child’s problem behavior, instead we repeatedly but thoughtfully introduce these situations when we can teach skills that are useful in that same situation.
The program was applied to 16 preschoolers attending a university-based full-day non-maternal care center.
I am going to use this line of work to discuss some effective strategies for the classroom.

9. Instruction Following
Evocative Event
Preschool life Skill
1. Adult calls child by name
Responds appropriately to name
2. Adult provides a single-step instruction
Complies with simple instructions
3. Adult provides a multi-step instruction
Complies with multi-step instructions
Preschool life skills were broken into four units, the first was instruction following; within this unit, there were three evocative events associated with three specific skills.
For instance, for PLS1, a teacher would call a child by their first name. If the child stopped what they were doing, looked up at the teacher, and said “yes” a preschool life skill was recorded.

10. Functional Communication
Evocative Event
Preschool life Skill
4. Difficult (impossible) tasks
Requests assistance (“Help me, please”)
5. Adult attention is diverted
Requests attention (“Excuse me”)
6. A preferred material is inaccessible or unavailable
Requests materials from adults (“May I have the ____, please).
7. A preferred material or area is being used by peer
Requests materials from peers (“May I have the ____, please).
The second unit was functional communication.
For instance with skill 4, the teacher would present a difficult task such as asking a preschooler to hand them the small box located on a high shelf. They then measured whether the child asked for help or engaged in an overt problem behavior, or just stood there.

11. Delay Tolerance Evocative Event Preschool life Skill
8. Adult delays access to requested materials
Tolerates delays imposed by adults
9. Peer delays access to requested materials
Tolerates delays imposed by peers
The third unit was delay tolerance. Tolerance was defined as staying in the area until the requested material was provided and not engaging in any additional manding during that time.

12. Friendship Skills Evocative Event Preschool life Skill
10. Receiving something from another person
Saying, “Thank you”
11. Another child enters the classroom or playgroup
Acknowledging/
Complimenting
12. Another child is without toys or materials
Offering/Sharing
13. Another person shows signs of pain or distress
Comforting (Are you okay?”)
The fourth unit was friendship skills.

13. To whom should these skills be taught?
All children in your homes and classrooms
How should these skills be taught?
Last question, to whom should these skills be taught?
Because of the risk associated with long-term child care, we felt that all children in the preschool classrooms should be taught the functional communicative skills.
To foreshadow we believe they should be taught and re-taught to all children independent of age or any particular risk factor. 13

14. BST: Behavior Skills Training (teaching involves more than expecting it or saying it)
Instructions/rationale
Modeling
Practice (role playing)
Feedback
Skill ---> descriptive praise
Problem of omission---> reminder of situation-specific behavior, presentation of another trial
Problem of commission ---> reminder of situation-specific behavior, presentation of another trial
Exposure
Description of skill, rationale for its importance
Occurred during circle times and meals at least 4 times
Modeling
Two teachers or a teacher and a child modeled skill for group during circle or meals
Practice (role playing)
Teachers and children practiced the skill during all daily activities (circle, meals, free-play, transitions, etc.)
Feedback
Engaging in the PLS was described and praised
If a PLS did not occur, the child was reminded of the situation-specific behavior, and another trial was initiated.
This was of teaching is not new but it is grossly underused, when do we use it—when the consequences matter—fire drills!!!

21. Prevention Model: A Replication
Our first attempt towards developing a curriculum to prevent problem behavior was published in in 2007,

22. Head Start Replication
Percentage of Trials in which a PLS was Observed
Initial Study
These data address the questions: How similar were results between the original and the replication study?
Each panel depicts the overall class performance across the 13 skills both prior to and following or class-wide teaching.
The top panel is from the replication study; the bottom panel includes the data from the original study in the university setting. Similar patterns in the data from each study…
Regarding the replication data: larger effects for unit one / smaller effects with units 2 & 3 / mixed differences with unit 4

23. What about individual kid performance?
Percentage of Trials in which a PLS was Observed

24. Head Start Replication
Initial Study
Replication
% change
Problems of
Commission:
-79%
-74%
Omission:
-66%
-59%
Preschool
Life Skills:
+406%
+501%

25. Acceptability of Class-wide PLS Program
The eight teachers who implemented the CWPLST were asked the extent of their agreement with 6 close-ended questions regarding the acceptability of CWPLST.

26. Acceptability Questionnaire Results
7 = Strongly agree, 4 = Not sure, 1 = Strongly Disagree
The majority of the children who experienced the Preschool Life Skills program benefited from the program.
Mean: 6.5 Range: 6 to 7
The classroom social environment was improved because of the group’s teaching of the Preschool Life Skills.
Mean: 6.9 Range: 6 to 7
The social and behavioral benefits that resulted from teaching the Preschool Life Skills are worth the effort invested in teaching the Preschool Life Skills.
Mean: 6.8 Range: 5 to 7
I would teach these same Preschool Life Skills in another child care program.
I would teach the Preschool Life Skills using the same teaching strategies in another child care program.
Mean: 6.4 Range: 5 to 7
I would recommend the Preschool Life Skills program to other teachers.
Mean: 7.0 Range: n/a

27. Advantages of PLS program
Challenging situations are not be avoided; they are introduced thoughtfully, systematically, and when skills can be taught.
Logical order to teaching skills (e.g., listener skills, then speaker skills)
Chained responses promotes extensive over-teaching
Gain attention  request  wait  thank  share
Provide function-based intervention to entire class simultaneously
Effective and socially valid (it works and teachers like it)
We like Class-wide preschool life skills training and plan to scale up its application and evaluation because
There is an underlying logic to the teaching sequence:
There is a recognizable logic to teaching Listener skills, and then speaker skills (receptive then expressive). There is a precedence and logic to increasing the rates of desirable behaviors such as functional language and then gaining stimulus control over them, for instance teaching waiting. It is sensible to teach children to take care of their needs, then teach them to be aware and take care of the needs of others. We like the over-teaching aspect of the program that is a function of the inherently chained responses
Class-wide application is practical and effective: Teachers and children are both aware of the skill of the day—makes it more likely teachers will teach (sometimes the children prompt it to happen) This is in stark contrast to what occur when you attempt individualized social skill goals for 16 children. Nevertheless, the boosters allow for individualization after teachers have learned to be effective with CWPLST and individual needs of children have been identified. In essence, the classwide application may be best understood as a complex and powerful prompt for incidental teaching of important social skills to occur throughout multiple daily activities.

28. Consideration: More intensive teaching is required if skills are not (or would not be) acquired on a class-wide basis
Beaulieu, L., Hanley, G. P., Roberson, A. (2012). Effects of responding to a name and group call on preschoolers compliance. Journal of Applied Behavior Analysis, 45,
Beaulieu, L., Hanley, G. P., & Roberson, A. A. (2013). Improving compliance by teaching preschoolers to help peers respond effectively to a name and group call. Journal of Applied Behavior Analysis, 46,
Beaulieu, L. & Hanley, G. P. (2014). Effects of a class-wide teacher-implemented program to promote preschooler compliance. Journal of Applied Behavior Analysis, 47,
This next mistake is a recent discovery…the mistake is in thinking that teaching functionally equivalent skills will prevent the development of problem behavior
You might be thinking : What the…. Because I appear to be contradicting my previous assertion.
A recent analysis conducted by one of our WNEC doctoral students taught us that contingencies to support skills need to be historic and present in current environment

29. RTI Model for Problem Behavior Tier 2: Teaching for some Tier 1:
Functional assessment then life skills taught to an individual student
Tier 3:
Assessment and teaching for one
Tier 2:
Teaching for some
Life skills taught
To small group
Life skills taught
to whole class
Tier 1:
Teaching for all 29

30. Precursor = Responding effectively to one’s name = stopping activity, looking at teacher, saying, “Yes,” and waiting until teacher says something.
We have some new data that addresses these issues.
I am going to give you a quick summary of the two complex analyses. A group of 12 children with the lowest levels of reported compliance across two classrooms were randomly assigned to experimental and control groups. This was conducted in inner city inclusive preschool classrooms. We measured the likelihood the children would respond effectively to their name (we called this a precursor behavior in this study). None did it much and there were no differences between the groups on this directly observed behavior.

31. Compliance = completing an instruction within 6 s
Precursor = Responding effectively to one’s name = stopping activity, looking at teacher, saying, “Yes,” and waiting until teacher says something.
Compliance = completing an instruction within 6 s
We also measured compliance to instructions and observed some variability across children (shown by the symbol distribution) but the mean compliance for the groups was similar.

32. We then taught the experimental group to respond effectively to their name (this is PLS 1), we then assessed whether this response would maintain under conditions similar to baseline. These data show that it did, and the same skill did not develop “naturally” for the control group kids. This was not surprising.

33. The effects on compliance were a little surprising
The effects on compliance were a little surprising. Despite the fact that there were no changes to the consequences for compliance or noncompliance we saw a reliable increase in compliance for the children in the experimental group, which maintained for 5 of the 6 children in that group. No concomitant changes in compliance were seen for the control group kids despite sharing a similar environment for the same amount of time.
These data showed that teaching children to respond effectively to their name increased the probability of compliance to one and two step instructions or teaching PLS 1 strengthened PLS 1, 2, and 3, that these effects persisted over time, and that none of these skills developed naturally or without the PLS program.

34. Take home point
Children who respond to their name by stopping what they are doing, look up at you and say ‘Yes’ comply with teacher instructions
Systematic screener for behavior disorders (SSBS)

35. Prevention Model: An RCT
Our first attempt towards developing a curriculum to prevent problem behavior was published in JABA in 2007, and we have since replicated the effects of the curriculum in different school settings such as Head Start classrooms.

36. Tier 2 example Example of Tier 2 teaching of life skills
Luczynski & Hanley (2012). Preventing the development of problem behavior by teaching functional communication and self-control skills to preschoolers. Journal of Applied behavior Analysis, 46,
Here are the data aggregated over time for each child in our initial baseline and our final maintenance phases. In baseline, the kids did not engage in these simple and very important skills. We saw some delay tolerance with a few children. Following teaching, all children in the treatment groups acquired the skills (they are the kids denoted with an asterisk) . No child in the control group acquired the skills. This bottom graph tells that story pretty succinctly. No skills for either; strong skill development only for the kids in the treatment group.
The implication is clear. These skills do not occur without explicit teaching. Teachers cannot just expect these skills; they are as socially constructed as our alphabet and therefore require explicit teaching to occur with regularity.

37. Data for one child in treatment group
A recent study by Kevin Luczyinski did, however, show the preventive efficacy of this approach as well as the trouble with avoiding evocative situations with young children.
In this study,12 preschoolers at risk for school failure due to functional skill deficits and early signs of problem behavior were randomly assigned to two groups:
6 kids experienced the life skills teaching program in daily small groups where they played games or worked on arts and crafts activities
6 other kids did not experience the life skills program but they did play the same games and worked on the same arts and crafts activities with the same people for the same amount of time.
Big difference: challenging situations were programmed and skills taught for the treatment group; challenging situations were not programmed and therefore skills were not taught for the treatment group.
In addition to the randomized group design; single subject designs were used to show the effects of teaching with individual children in the treatment group. I will show you the skill acquisition data for 1 child within a multiple probe design. Gaining teachers attention. Requesting materials or help. Tolerating delays and denials.
You can see that we measured these skills over time and they developed when and only when they were directly taught (in this case using behavioral skills training). These skills persisted even when the teaching package was removed.

38. Conclusion: These life skills do not occur without explicit teaching
Here are the data aggregated over time for each child in our initial baseline and our final maintenance phases. In baseline, the kids did not engage in these simple and very important skills. We saw some delay tolerance with a few children. Following teaching, all children in the treatment groups acquired the skills (they are the kids denoted with an asterisk) . No child in the control group acquired the skills. This bottom graph tells that story pretty succinctly. No skills for either; strong skill development only for the kids in the treatment group.
The implication is clear. These skills do not occur without explicit teaching. Teachers cannot just expect these skills; they are as socially constructed as our alphabet and therefore require explicit teaching to occur with regularity.
Conclusion: These life skills do not occur without explicit teaching

39. Problem Behavior
Equally important were the effects on problem behavior. Despite occurring to a greater extent in the initial baseline than that observed in the control group, problem behavior was eliminated for all children in the treatment group. In other words, those who acquired the social skills no longer engaged in grabbing, yelling, hitting, rude talking, etc. These same problem behaviors not only maintained for the children in the control group, they increased substantially for all children in the control group.
It is these data that lead us to conclude that teaching the life skills prevented the development of problem behavior in these high-risk preschoolers
It seems that when we avoided evocative situations by providing children in the control group with noncontingent attention, materials, and assistance, we set the children up for problem behavior when these evocative situations were re-introduced in our final baseline probes. It is these data that make me leery of typical proactive approaches in which problem situations are altogether avoided.
Conclusion: Teaching the life skills prevented the development of problem behavior in these high-risk preschoolers

40. Teaching Life Skills Prevention of Problem Behavior possible by:
(within an RTI framework)
Good listening = compliance
Using their words = functional communication
Self control = skills to tolerate delays, denials, and unexpected changes
and teaching involves more than just saying it and reminding kids of expected behavior.

41. Tier 3 may be required for some learners
Individualized assessment and teaching for one
Also known as functional assessment and function-based treatment 41

42. Good luck with all that you do for all who you teach and provide care
For more information go to:
Contact info.:
Gregory P. Hanley, Ph.D., BCBA-D
Psychology Department
Western New England University
1215 Wilbraham Road
Springfield, Massachusetts 01119
Thank you very much.
Most of these changes to #/length of sessions, measures, etc. are like putting racing stripes on a big old Cadillac, that Cadillac will move but it is still going to guzzle up your time, the brakes don’t work so well and it never had seat belts to begin with, so you may lose control and it may get dangerous, but ultimately the problem is that, more times than not, that old Cadillac is not going to get you where you want to go.