1. Positive Behaviour Support and how it can be used as a framework to support classroom behaviour management of students with autism in a special school.
Janice Moyston

2. What is it about?
The objective of the study was to find out how Positive Behaviour Support was perceived by teaching staff in a special educational needs school; how effective it was as a framework for whole class behaviour management and whether it was useful as a platform for teaching emotional regulation skills to students with autism.
The study was a qualitative small scale (sample size 12), single case study utilising a multi- strategy /mixed method approach including semi-structured interviews using prompts (2), a self-administered questionnaire (9) and narrative observations (1).  The sample included a cross section of participants – student, senior and middle leaders, class teachers, HLTA, TA and learning support assistants.

3. What did I find out?
It was found that perceptions of positive behaviour support were positive and that teaching staff were following its principles when managing challenging behaviour in their classrooms.
Several themes were revealed during the research, including the use of positive reinforcement, the importance of having a whole school strategy for the teaching of communication and the need for early identification of antecedents leading to early intervention to reduce instances of emotional dysregulation.
The research brought to light that limited use was made of evidence-based behaviour management interventions, though positive reinforcement was widely used. It was also found that interventions specifically aimed at reducing emotional dysregulation would be a beneficial addition to the school’s behaviour management toolkit.

4. What is PBS?
Positive Behaviour Support (PBS) emerged out of Applied Behaviour Analysis (ABA) in the late 1980s /early 1990s as an intervention and support strategy to improve the lives of students with autism, particularly those with challenging behaviours (Dunlap 2006). The link to ABA is most evident in the use of direct interventions (instrumental learning, positive reinforcement, stimulus control) and, the use of functional assessment and analysis tools, all targeted at the individual level (Dunlap 2006).
PBS has been described as the skills that enable individuals to find satisfaction and success in their day-to-day lives, for example socially, in employment, recreationally, academically and in their communities. (Carr, et al., 2002).

5. What role does emotional regulation play in PBS?
Emotional self-regulation is the ability for people to harness appropriate behaviour management skills to modify the strength and time-related features of emotions contextually and in a goal-oriented way.
Emotional self-regulation is seen as different from the emotions themselves and skills can be taught that are response-focussed or antecedent-focussed. Difficulties with emotional self-regulation play a part in the inappropriate behaviours displayed by many people with neurological disorders (Mazefsky and White, 2014).

6. What role does emotional regulation play in PBS?
Inappropriate behaviours are sometimes seen as deliberate, but more accurately should be seen as the inability to effectively manage their own emotional state when faced with overstimulation or stressful situations (Mazefsky and White, 2014).

7. What role does emotional regulation play in PBS?
One of the primary areas of concern for students with autism is the difficulty in identifying, differentiating and describing how they (and others) feel. An inability to accurately identify and label the emotions impedes ‘effortful’ and ‘successful’ emotional self-regulation (Ciarrochi, et al., 2008; Barrett, et al., 2001,).
This difficulty is further compromised by poor language development (Saarni, 1999) and further complications relating to cognition, theory of mind and social interaction (Samson, et al., 2012).
Students with autism with poor emotional self-regulation skills have an increased likelihood of displaying high levels of anxiety and agitation.

8. Teaching emotional self-regulation skills as a way to improve emotional wellbeing
SCERTS emotional regulation aspect ‘supports a child’s ability to regulate emotional arousal’ (Prizant, et al., 2006) and therefore makes them available for learning (i.e. centring on listening and attention, engagement, information processing, social interaction and participation).
In this study SCERTS emotional regulation targets were coupled with a CBT intervention (a transactional support) to assist students with understanding their own emotions and finding ways to cope with them.

9. Teaching emotional self-regulation skills as a way to improve emotional wellbeing
Preliminary results from a variety of research studies indicate that CBT interventions created for students with ASD may prove effective in minimizing anxiety. (Reaven, 2011; Woods, et al., 2009; Moree, et al., 2010; Storch, et al., 2013).
One such programme is the ‘Exploring Feelings’ programme created by Dr Tony Attwood. The programme has been designed for school-age children and targets anxiety and anger. A randomized controlled trial of 71 children aged conducted by Sofronoff, Attwood and Hinton (2005) found significant decreases in anxiety symptoms reported by parents. Initial trials also suggest that it improves emotion labelling and regulation. (Mazefsky and White, 2014).

10. Teaching emotional self-regulation skills as a way to improve emotional wellbeing
The intervention took the form of four half hour lessons, once a week. The purpose of the intervention was to see whether there was any take-up of the emotional regulation skills presented during the lessons. The student (Student A) was observed for 15 minutes during two lessons, with an additional observation taking place during the morning circle session (an interactive session in which students greet each other, identify how they feel using symbols, etc).

11. Teaching emotional self-regulation skills as a way to improve emotional wellbeing
In the first observation, an Exploring Feelings lesson about happiness, the class were asked to look at a selection of visuals which included special interests and other activities that the students were known to enjoy. Each student was then asked to identify one or more activities that made them feel happy. Student A looked at the symbols attentively and was able to identify swimming and eating as activities that made her feel happy. The lesson included an opportunity for movement and students were encouraged to dance to a piece of music and then say how their body felt. Student A was able to say that she felt excited. During the plenary stage of the lesson, students were asked to identify how they felt on a scale ranging from happy to sad. The scale was placed on the floor and symbols were used to denote the degree of emotion along the scale. Student A was able to say that she felt happy and stand in the correct position on the scale.

12. Teaching emotional self-regulation skills as a way to improve emotional wellbeing
The second observation took place during the daily morning circle. Students watched a video showing a range of emotions, for example happy, excited, bored, angry, worried, confused, etc. Each emotion was accompanied by its name and a visual mnemonic to support the students understanding. Student A was able to copy the mnemonics and emotion words. The students then indicated how they were feeling that morning, by dragging and dropping a hand symbol onto the symbol that best fit their emotion. Student A was able to do so with ease. The students were also asked what they would need to do if they felt angry or sad. Student A was able to say “relax”, which involved going to the relaxation room to calm.

13. Teaching emotional self-regulation skills as a way to improve emotional wellbeing
Displayed in the classroom were symbols showing different emotions and giving pointers as to what students can do if they were feeling those emotions. For example, the symbol for relax shows the emotion – angry. The relaxation room is a safe, comfortable place for students to go to calm when they become dysregulated. Student A (self-initiated) used the space successfully to calm when she became anxious at the absence of various classmates and showed awareness that it is somewhere that she can go to relax when she needs to. In this way she has been given an opportunity to choose what happens (Kerns and Clemens, 2007), rather than being told what to do and the relaxation room has not been used in a restrictive way, as it is up to the student to decide if they want to go there and when they want to leave.

14. Teaching emotional self-regulation skills as a way to improve emotional wellbeing
The final observation occurred during an Exploring Feelings session about relaxation. I led students through several relaxation exercises including movement, massage, deep breathing and a guided relaxation. Student A was able to attend to each exercise. At the end of the session, each student was asked how they felt. Student A said that she felt calm.
Student A was able to follow the instructions well and this lesson will be repeated in the future to see whether she is able to use any of these relaxation exercises when she is feeling stressed. It will be interesting to see whether the use of social prompts (e.g. self talk in the form of the instruction to breathe deeply) will become embedded as a means for students to practice emotional regulation in the future (Carter and Hughes, 2007).

15. Where could we go from here?
Additional research, particularly in the areas of evidence-based behaviour management strategies, including interventions specific to teaching emotional regulation skills.
Further input from senior leadership in the formulation of specific programmes of continuing professional development to improve staff knowledge, understanding and use of the most effective behaviour management, communication and emotional regulation strategies and interventions;
The establishment of a whole school target setting scheme (possibly by the adaptation of SCERTS [Prizant, et al., 2006] or the formulation of targets by the school) that focusses on communication, emotional understanding and the use of evidence-based interventions that could be included on the positive and proactive support plan.