1. Form Ever Follows Function: Classroom-based Behavioral Interventions for Children and Youth with TBI Beth Urbanczyk, MSCCC Behavior Analyst

2. Functional Analysis and Assessment of Behavior A set of processes for defining the events in an environment that reliably predict and maintain problem behaviors. (ONeill, et al 1997) Methods: interviews, rating scales, direct observation, etc.

3. Functional Behavioral Assessment and Analysis Outcomes include: Clear description of challenging behaviors Identification of who, what, where, etc that predict when behavior(s) will/wont occur Identify consequences that maintain behavior(s)

4. Functional Behavioral Assessment and Analysis Collection of direct observation data that support summary statements. Data Collection: Scatterplot with an embedded rating scale See samples in handouts

5. Values and Functional Assessment Conduct behavioral support with dignity of the person as primary concern. A persons behavior is functional. Conduct FAB to understand the structure/function of those behaviors so we can teach/promote effective alternatives.

6. Values and Functional Assessment Process for looking at relationships between behavior and the environment. Not simply a review of the person with challenging behaviors.

7. Approaches to FA Informant Methods: Talk to individual with ABI and other key stakeholders (e.g. teachers, SLP, Principal, Art teacher, family, etc.)

8. Approaches to FA Direct Observation by Behavior Consultant, teachers, assistants, etc. Train staff to be good observers! A-B-C (dont forget Setting Events)

9. Review of Data Review your data. Please see sample in your handouts. Provide precise descriptions of problem behaviors.

10. Precise Behavioral Descriptions: NOT! Out of chair Hitting others Running in hall Crawling on knees in hall Not staying in seat (café) Changing Centers Getting Water (not asking) Off Rest Mat and on and on

11. Precise Behavioral Descriptions How many categories can you reduce the previous list of behaviors to? Thoughts and suggestions:

12. Summary Statements This is where you develop your hypothesis. Get staff and other stakeholders thinking about function of behavior not topography.

13. Form Ever Follows Function List and describe the functions of the childs behaviors. Escape, attention, access, sensory, etc. Finally, identify a plan!

14. Positive Behavioral Momentum Preferred Activities Choices and Control Positive Emotional States Positive Routine Activity Engagement and Completion

15. Positive Setting Events (Feeney, 2001) Environmental support Choices Positive routines Positive emotional states Positive roles Control Preferred activities

16. Positive Setting Events (Feeney, 2001) Success with meaningful tasks tend to result in: –Activity engagement –Completion of tasks –Positive environment

17. Proactive Communication –Always give information. Tell the person: Where you are going. How much you want the person to do. How long you want the person to do something. –Write things down. –Dont say no, say try again.

18. Even More Proactive Communication Ask Questions & Give Choices What did I say? Do you remember? What can you do now? What should you do now? Is this going to help you? How do you want me to help you? What do you want?

19. Antecedent Management Instructional Control (Luria, 1961; Russo, Cataldo, & Cushing, 1983) –Identify a cue which means STOP. –Cue the person to stop at a natural time. –Repeat this procedure throughout the daily routine. –Use when the person demonstrates problem behaviors. Instructional Control (Luria, 1961; Russo, Cataldo, & Cushing, 1983)

20. Teach how to behave Direct Instruction (Engelmann & Carnine, 1982) –General Case Responding (Becker & Emgelmann, 1978) –General Case Programming (Horner, McDonnell, & Bellamy, 1986) Define instructional universe. Define range of acceptable variation within universe. Select teaching examples. Sequence examples. Teach examples.

21. Teach how to behave Label Behaviors –Identify and reflect. Objectively label the behavior(s). Use one or two word descriptors of the behavior(s). Reflect the behavior(s) back to the person. –Identify alternatives. –Identify feelings and emotions.

22. Natural Consequences (not punishment) –Motivational Assessment (Durand, 1989) Identifying a range of naturally occurring reinforcers. Providing a range of reinforcers. –Activity or object acquisition. –Demand avoidance. –Attention. –Grandmas Rule. –The You could do that...what will happen Approach

23. Non-Aversive Approaches to Challenging Behavior: C Self Monitoring and Self Evaluation –Self Evaluation Scale (Feeney, 1990) Self evaluation (1-10) Peer evaluation (1-10) Staff evaluation (1-10) –What helped / What didnt help Guided Self generated

24. Personal Metaphors Brett Favre is the Quarterback for the Green Bay Packers. Brett Favre is my hero. A hero is someone I like a lot. A hero does good things.

25. Brett Favre does good things. Some of those good things are –exercises, eats well and takes care of himself. –Brett Farve makes a plan for the Packers before each play. The plan lets the players know what to do and when to do it. –Brett Farve takes care of his hands so they dont get hurt - HE KEEPS HIS HANDS TO HIMSELF. –Brett Farve follows the Coachs directions.

26. Brett Favre and Scott I want to be a big man like Brett Favre. To be a big man like Brett Favre, I need to: Follow the teachers directions. My teachers are like Brett Favres coaches. I will keep my hands to myself. I have to take care of my hands like Brett Favre takes care of his hands. I will make a plan with my teacher before each class. Brett Favre and his coaches make plans for the Packers before each class. I will try my best each day to act like Brett Favre.

27. Managing Behavioral Crises Keep a Stoneface. Redirection. Active Listening & Supportive Questioning –Ventilation – Empathy –Identification – Problem Solving –Reflection Manage the environment. –General space. –Personal space.

28. Managing Crises (Some Donts) Plant an idea for a negative behavior. –I know youre mad but, you better not... –Dont even think about... Threaten with consequences. –Creating confrontation. –I dare you. –Creates negative emotions. Present commands as questions. –Would you like to?

29. There is no magic! Hard work Involvement of school personnel, family and child Consistency Commitment Sense of humor

30. Thanks for your time! If you want to contact me: Try this way: Beth@scarabhealth.co m or 615-319-2473Beth@scarabhealth.co m