BEHAVIOR SUPPORT PLANNING Mapping an Individual Behavior Support Plan using the Pyramid Model Practices ECN Training Thursday April 4 th, 2013 Melissa.

BEHAVIOR SUPPORT PLANNING Mapping an Individual Behavior Support Plan using the Pyramid Model Practices ECN Training Thursday April 4 th, 2013 Melissa Binkley & Beth Vorhaus

The Pyramid Model [Assessment-based interventions result in individualized behavior support plans.] Prevention Universal Promotion Treatment Module 3

Behavior Potential unmet need Is communicating… Skill to be developed

1. What is the ‘tip of the iceberg’ behavior? 2. What social-emotional skill is needing support? 3. What might be going on for this child? (possible unmet needs) A 6 month-old cries for long periods of time unless held by his caregiver…

Old Way versus New Way Old Way General intervention for all behavior challenges Intervention is reactive Focus on behavior reduction Quick fix New Way Intervention matched to purpose of the behavior Intervention is proactive Focus on teaching new skills Long-term interventions

Behavior Support Plan Behavior Hypotheses- Purpose of the behavior; your best guess about why the behavior occurs Prevention Strategies- Ways to make events and interactions that trigger challenging behavior easier for the child to manage Replacement Skills– New skills to teach throughout the day to replace the challenging behavior Responses- What adults will do when the challenging behavior occurs to ensure that the challenging behavior is not maintained and the new skill is learned

Behavior Hypothesis Expands on the behavior equation and incorporates what you have learned from the observations and interviews Includes information about: Function of the behavior Triggers of the challenging behavior Description of the challenging behavior Responses that maintain the challenging behavior HO: Hypothesis Statement

Data Collection Collecting data about a child and the challenging behavior helps us identify the form and understand the function. Information that is collected to determine the function of a behavior is called a “Functional Assessment” Literally, the assessment of the behavior’s function

Conducting a Functional Assessment Observe the child in target routines and settings Look for situations that predict challenging behavior and situations that predict appropriate behavior. Interview persons most familiar with the child Parents, Grandparents, Teachers Review records

Behavior Support Plan Behavior Hypotheses- Purpose of the behavior, your best guess about why the behavior occurs Prevention Strategies- Ways to make events and interactions that trigger challenging behavior easier for the child to manage Replacement Skills– New skills to teach throughout the day to replace the challenging behavior Responses- What adults will do when the challenging behavior occurs to ensure that the challenging behavior is not maintained and the new skill is learned

Look at the Function of the Behavior Ask yourself… How can the environment be changed to reduce the likelihood that challenging behavior will occur? What can be done to make challenging behavior irrelevant? What procedures can I select that fit in the natural routines and structure of the classroom or family? How can I build on what works? What can be done to help the child not respond to the trigger or change the trigger so it does not cause challenging behavior?

Teaching Replacement Skills Replacement Skills are alternative behavior to challenging behavior. Replacement skills must be efficient and effective (i.e., work quickly for the child). Make sure the reward for appropriate behavior is consistent.

Competing Behavior Equation Child told sibling gets a turn. Child yells, kicks, throws. Adult gives child another turn. Child asks for one more turn. Adult says “one more turn, then (siblings’s name)’s turn” and gives turn.

Functional Equivalence Replacement skills should have functional equivalence ‾ Identify an acceptable way that the child can deliver the same message. ‾ Make sure that the new response is socially appropriate and will access the child’s desired outcome. Teach the child a skill that honors that function of the behavior (e.g., if child wants out of activity, teach child to gesture “finished”).

Response to Challenging Behavior Respond in a way that will make challenging behavior ineffective. Make sure rewards for appropriate behavior are equal to or exceed rewards for challenging behavior.

Safety-Net Procedures If a child is in danger of harming self or others, you must first be concerned about safety. You may hold a child or remove a child from the situation to keep children safe. Safety-net procedures may be planned for children who have a history of dangerous outbursts. Safety-net procedures only keep children safe; they do not change behavior. Safety-net procedures are appropriate only when there is also a full behavior support plan or intention to develop a plan.

Developing an Individual Support Plan 1. Identify the basic equation (trigger, behavior, maintaining consequence) of the challenging behavior. 2. Identify the function of the challenging behavior 3. Brainstorm Prevention Strategies 4. Brainstorm ideas about what Replacement Skills should be taught to replace challenging behavior 5. Brainstorm ideas about how to Respond to challenging behavior when it occurs. 6. Implement with Intentionality, then: Review, Edit, Tweak, Reapply…

Keep in Mind: Behavior Support Plans also… Subscribe to Program Rules & Protocol Outline clear steps in developing a plan to address the behavior Identify role/participants on the team (Parents/Family, Teachers, Home Visitors, Assisting Teachers/Paraprofessionals, Therapists, Administrative Staff, Mental Health Consultant, Others…?) Lay out how progress will be reviewed, how changes will be made in the plan Stipulate how decisions will be made about ending or modifying the intervention protocol

Behavior Support Plan Development Step One Identify the basic equation (trigger, behavior, maintaining consequence) of the challenging behavior. TriggerBehavior Maintaining Consequence Setting Events (if applicable): Handout 4 & 5

Behavior Support Plan Development Step Two Identify the function of the challenging behavior. TriggerBehavior Maintaining Consequence Setting Events (if applicable): Function:

Behavior Support Plan Development Step Three Brainstorm Prevention Strategies o Strategies to make routines or activities easier for the child o Strategies to soften the triggers

TriggerBehavior Maintaining Consequence Preventions Function:

Behavior Support Plan Development Step Four Brainstorm ideas about what Replacement Skills should be taught to replace challenging behavior. o Think about what skills the child already has o Think about what skills can use scaffolding

TriggerBehavior Maintaining Consequence Function: PreventionsNew Skills

Behavior Support Plan Development Step Five Brainstorm ideas about how to Respond to challenging behavior when it occurs. o Consider current demands on teachers o Keep responses easy to use/remember

TriggerBehaviorMaintaining Consequence PreventionsNew SkillsNew Responses To Challenging Behavior: To Use of New Skill: Function:

Behavior Support Plan Development Step Six Intentional Implementation - Immediate: Review plan ideas; eliminate pieces that don’t fit or are too difficult for team to do. Emphasize that each column is necessary. Create an Action Plan so that each team member knows what, when, and how the strategies will be implemented. Intentional Implementation - Ongoing: Repeat process for other routines, settings, or behavior functions. Consult with a mental health professional if the child is not responding and the intensity, frequency, and duration of the behavior is not improving.

Plan Development Tips: Develop plan using plain language. Develop action plan of who will produce what components needed to implement the plan. Make sure plan will fit with routines, activities, and values of family and teaching staff. Design components that are easy to use, easy to remember. Plan must accommodate competing demands on teaching staff and family. Focus on ONE behavior at a time. Develop mini-plans for difficult routines.

Activity 3-4

MICHAEL’S CHALLENGING BEHAVIOR Case Study Example

Michael’s Challenging Behavior Example 1:

Michael’s Challenging Behavior Example 2:

Michael’s Functional Assessment Interview Key Points: Same pattern at home as at school Child not sleeping through the night Eats very quickly & takes food from others Limited in choices he gets to make at home Eating & Free Play are most frequent settings for challenging behavior Set Offs: Mom talking on phone/attending to others Engaging in behavior leads to pay-off, “almost every time” Likes to: read w/adult, play alone with adult, play with cars & bouncy balls

Behavior Support Plan Development Step One Identify the basic equation (trigger, behavior, maintaining consequence) of Michael’s challenging behavior. Handout 4 & 5 Trigger Group play: outside play with peers Setting Events (if Applicable): Behavior Verbal Aggression Physical Aggression Property Destruction Maintaining Consequence Peers give up toy/item Peers leave area Adults intervene with negative attention

Identify the function of Michael’s challenging behavior. Behavior Verbal Aggression Physical Aggression Property Destruction Function: Obtain Toy/Attention Behavior Support Plan Development Step Two Trigger Group play: outside play with peers Setting Events (if Applicable): Maintaining Consequence Peers give up toy/item Peers leave area Adults intervene with negative attention

Michael’s Hypothesis Statement Remember: Triggers of the challenging behavior Description of the challenging behavior Function of the behavior Responses that maintain the challenging behavior In group play situations (outside play/centers),... Michael uses verbal aggression (threats), physical aggression (hit, push, kick, punch), and property destruction (throwing or banging toys)… to obtain toys and/or join play. When this occurs, the peer relinquishes the desired toy and leaves the play area and/or an adult intervenes and provides Michael with excessive negative attention.

Step 3: Preventions o Pre-teach skills via scripted story. o Use visual cards to help him remember lessons when in difficult situation. Behavior Verbal Aggression Physical Aggression Property Destruction Function: Obtain Toy/Attention Trigger Group play: outside play with peers Setting Events (if Applicable): Maintaining Consequence Peers give up toy/item Peers leave area Adults intervene with negative attention Preventions Pre-teach skills by role playing via scripted story Use visual cards to help him remember lessons when in difficult situation Self-monitoring form to work on new skills Replacement SkillsNew Responses

Step 4: Replacement Skills o Asking to play, Everyone can play with the toys, Flexibility, accepting other’s ideas/space, Asking for teacher’s help, Self-monitoring form to work on social goals. Behavior Verbal Aggression Physical Aggression Property Destruction Function: Obtain Toy/Attention Trigger Group play: outside play with peers Setting Events (if Applicable): Maintaining Consequence Peers give up toy/item Peers leave area Adults intervene with negative attention Preventions Pre-teach skills by role playing via scripted story Use visual cards to help him remember lessons when in difficult situation Self-monitoring form to work on new skills Replacement Skills Asking to play Everyone can play with the toys Asking for teacher’s help New Responses

Step 5: New Responses o Immediately respond to his requests for help. o Intervene to prevent harm by providing attention/support to child who is attacked. o Provide certificate and acknowledge positive behavior at end of each day for successfully achieving goals. Behavior Verbal Aggression Physical Aggression Property Destruction Function: Obtain Toy/Attention Trigger Group play: outside play with peers Setting Events (if Applicable): Maintaining Consequence Peers give up toy/item Peers leave area Adults intervene with negative attention Preventions Pre-teach skills by role playing via scripted story Use visual cards to help him remember lessons when in difficult situation Self-monitoring form to work on new skills Replacement Skills Asking to play Everyone can play with the toys Asking for teacher’s help New Responses To Challenging Behavior: Anticipate & cue to use new skill. Intervene to prevent harm by providing attention/support to child who is attacked To Use of New Skill: When asks, respond Provide certificate/star and acknowledge positive behavior. Fade certificate/star

Step 6: Intentional Implementation Child Name: Michael Program: Village Pre-K Date: 10/11 Planning Objectives: Develop behavior support plan materials to assist Tim at home and in preschool NeedAction Steps Person Responsible Date Follow-up 1. Develop scripted story with 4 chapters: ask to play take turns go with the flow stop, think and do Write text. Insert pictures. Print story. Melissa, Beth 10/24 By 10/28 By 10/28 Send story home so they too can read at home to prepare for school. Action Planning Form

NeedAction StepsPerson Responsible/ Date Follow-up 2. Develop cue cards for each chapter in story. A. Create. B. Print. C. Laminate. D. Punch hole and attach to ring Melissa by 10/24Discuss via phone 2 weeks after use, or earlier if questions arise. 3. Develop self monitoring goal sheet: ask to play take turns go with the flow stop, think, and do Create and print with one goal at a time, add each goal as he does the prior goal(s). Beth, Melissa By 10/28 Send sample goal sheet home and discuss after 2 weeks of use. Action Planning Form (con’t.)

NeedAction StepsPerson Responsible/ Date Follow-up 4. Develop certificate. Create and print many. Beth By 10/28 Send certificates home as he completes goals (no comment from parents if no certificate comes home). Action Planning Form (con’t)

Implementation Teach classroom staff/family/other adults – review strategies, demonstrate or guide, provide reinforcement (not criticism). Make sure everyone on the team understands the plan. Design supports that help the adults remember the plan (posted mini-plan, reminder signs, checklists). Be cautious about extinction bursts– offer support, availability. Ask for time, assure classroom staff/family that you are committed to creating a plan that will work. Begin plan implementation when all pieces have been developed (behavior support plan, materials, activity/routine matrix, instructional procedures, and outcome monitoring form).

Monitoring Outcomes Helps determine the impact of the behavior support plan (or lack of impact!) Allows you to alter the plan as needed Remember to KISS it!

MondayTuesdayWednesdayThursdayFridaySaturday 444444 333333 222222 111111 Michael’s Playtime 4 Laughing, stayed 3 Cooperated, stayed briefly 2 Fussed, took several turns 1 Cried, refused to play

Average Aggression Child’s Name: __Michael____ Week of: ___4/1/13-4/5/13_________ Check the number of times the child is aggressive during the activity. Aggression includes: hits, pinches, pulls hair, bites, kicks, & scratches. ActivityMon.Tues.Wed.Thurs.Fri.Average Arrival ___0 times _x__1-5 times __5-10 times ___10-15 ___15-20 ___+20 ___0 times _x__1-5 times ___5-10 times ___10-15 ___15-20 ___+20 _x__0 times ___1-5 times ___5-10 times ___10-15 ___15-20 ___+20 _x__0 times ___1-5 times ___5-10 times ___10-15 ___15-20 ___+20 _x__0 times ___1-5 times ___5-10 times ___10-15 ___15-20 ___+20 __x_0 times ___1-5 times ___5-10 times ___10-15 ___15-20 ___+20 Circle ___0 times ___1-5 times __x_5-10 times ___10-15 ___15-20 ___+20 ___0 times __x_1-5 times ___5-10 times ___10-15 ___15-20 ___+20 ___0 times _x__1-5 times ___5-10 times ___10-15 ___15-20 ___+20 __x_0 times ___1-5 times ___5-10 times ___10-15 ___15-20 ___+20 _x__0 times ___1-5 times ___5-10 times ___10-15 ___15-20 ___+20 ___0 times __x_1-5 times ___5-10 times ___10-15 ___15-20 ___+20 Lunch ___0 times ___1-5 times __x_5-10 times ___10-15 ___15-20 ___+20 ___0 times ___1-5 times __x_5-10 times ___10-15 ___15-20 ___+20 ___0 times _x__1-5 times ___5-10 times ___10-15 ___15-20 ___+20 ___0 times _x__1-5 times ___5-10 times ___10-15 ___15-20 ___+20 ___0 times _x__1-5 times ___5-10 times ___10-15 ___15-20 ___+20 ___0 times __x_1-5 times _x__5-10 times ___10-15 ___15-20 ___+20 Average ___0 times ___1-5 times _x_5-10 times ___10-15 ___15-20 ___+20 ___0 times __x_1-5 times ___5-10 times ___10-15 ___15-20 ___+20 ___0 times _x__1-5 times ___5-10 times ___10-15 ___15-20 ___+20 _x__0 times ___1-5 times ___5-10 times ___10-15 ___15-20 ___+20 _x__0 times ___1-5 times ___5-10 times ___10-15 ___15-20 ___+20 ___0 times _x__1-5 times ___5-10 times ___10-15 ___15-20 ___+20

Child’s Transitions Week of: _________________ MondayTuesdayWednesdayThursdayFriday Arrival0 1 2 3 Circle0 1 2 3 Nap0 1 2 3 Clean-up0 1 2 3 Other: Bus Ride 0 1 2 3 Average Score 3 Average Score 2.2 Average Score 1.4 Average Score 1.4 Average Score.8 Rate the problem behavior: 0 = no problems, 1 = whining, resisting, 2 = screaming, falling on floor, 3 = screaming, hitting, other aggression.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8.8

If Challenging Behavior Returns First ‾ Review plan and make sure it is being implemented as planned. ‾ Review evaluation data to determine if the pattern is an extinction burst (worse before it gets better). ‾ Examine events to see if there are new triggers for behavior. Then ‾ Restore support plan and implement with fidelity; or ‾ Continue plan through extinction burst; or ‾ Add components to plan to address new triggers; or ‾ Conduct a new functional assessment and develop new support strategies.

Example of Support Plan Checklist Michael’s Support Plan Implementation Implementation ItemsIn Place/Occurring? Yes Proof: Yes Proof: Yes Proof: Yes Proof: No Sometimes Support providers enter into play activities and teach Michael new play routines. Adults provide support by scaffolding Michael’s interactions in play routines outside and during centers. Adults assist Michael with turn-taking interactions by moving into play activities and mediating his social exchanges; and then scaffold the interaction. Adults facilitate the use of communication repair strategies by Michael. (Michael may use unintelligible mumbling or aggression if adults fail to quickly interpret his message) Pre-teach Michael through the use of a scripted story the following skills: asking to play, everyone can play (turn taking), being flexible and accepting other’s ideas and space, and asking the teacher for help.

Example of Support Plan Checklist Michael’s Support Plan Implementation (cont.) Michael uses a self-monitoring form to indicate if he accomplished his social skills goals. One goal is introduced at a time. YesNoSometimes At the end of centers, a teacher helps Michael use the form to record if he was successful in meeting his goal(s) and then provides a certificate for Michael to take home to celebrate the use of the new skill. YesNoSometimes Michael receives positive statements about his use of appropriate peer play behavior frequently throughout the day in a natural fashion. YesNoSometimes

Example of Support Plan Checklist Michael’s Support Plan Implementation (cont.) When Michael has difficulty with initiating interaction with his peers during play, anticipate the difficulty and cue him. YesNoSometimes If Michael becomes angry, confused, and/or frustrated and looks like he is about to use aggression, cue him to use the “Turtle Technique” and help him through the steps. YesNoSometimes If Michael using aggression, intervene to prevent harm by providing attention/support to the child who is hurt and/or upset. YesNoSometimes

Activity: Develop a Behavior Support Plan (For identified child) 1. Write at least 3 “Observations.” (Use memory to develop observation cards for this example only.) 2. Based on “Observations” determine the function of the behavior and create Behavior Hypothesis. 3. Develop a Behavior Support Plan for one hypothesis statement. I. What Prevention Strategies could you put in place for target child? II. What Replacement Skills would you teach the target child? III. What New Responses would you develop for parents, teachers, other adults in child’s life? 4. Create an Action Plan detailing who will create/implement what for the child. 5. Create Monitoring Plan – Choose Data Tool & Develop Support Plan Checklist 6. Be prepared to share your plan with the group.

Major Messages 1. The behavior support plan includes four parts: behavior hypotheses, prevention strategies, replacement skills, and new responses. Prevention strategies are used to soften the triggers of challenging behavior. Replacement skills (to replace challenging behavior) are taught systematically and throughout the day. 2. Data collection needs to be easy to collect on simple forms: “KISS” it (Keep It So Simple). 3. Behavior support efforts are ongoing and outcomes must be monitored.

Questions? For More Information: http://teamtn.tnvoices.org http://csefel.vanderbilt.edu/resources/ strategies.html#toolsplans http://csefel.vanderbilt.edu/resources/ strategies.html#toolsplans http://challengingbehavior.org/explore /pbs/pbs.htm http://challengingbehavior.org/explore /pbs/pbs.htm

BEHAVIOR SUPPORT PLANNING Mapping an Individual Behavior Support Plan using the Pyramid Model Practices ECN Training Thursday April 4 th, 2013 Melissa.

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BEHAVIOR SUPPORT PLANNING Mapping an Individual Behavior Support Plan using the Pyramid Model Practices ECN Training Thursday April 4 th, 2013 Melissa.

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