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

Form Ever Follows Function:Classroom-based Behavioral Interventions for Children and

Youth with TBIBeth Urbanczyk, MSCCC

Behavior Analyst

Functional Analysis and Assessment of Behavior

• A set of processes for defining the events in an environment that reliably predict and maintain problem behaviors. (O’Neill, et al 1997)

• Methods: interviews, rating scales, direct observation, etc.

Functional Behavioral Assessment and Analysis

• Outcomes include:

• Clear description of challenging behaviors

• Identification of who, what, where, etc that predict when behavior(s) will/won’t occur

• Identify consequences that maintain behavior(s)

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

Values and Functional Assessment

• Conduct behavioral support with dignity of the person as primary concern.

• A person’s behavior is functional.

• Conduct FAB to understand the structure/function of those behaviors so we can teach/promote effective alternatives.

Values and Functional Assessment

• Process for looking at relationships between behavior and the environment.

• Not simply a review of the person with challenging behaviors.

Approaches to FA

• Informant Methods:

Talk to individual with ABI and other key stakeholders (e.g. teachers, SLP, Principal, Art teacher, family, etc.)

Approaches to FA

• Direct Observation by Behavior Consultant, teachers, assistants, etc.

• Train staff to be good observers!

• A-B-C (don’t forget Setting Events)

Review of Data

• Review your data.• Please see sample in

your handouts.• Provide precise

descriptions of problem behaviors.

Precise Behavioral Descriptions: NOT!

• Out of chair

• Hitting others

• Running in hall

• Crawling on knee’s in hall

• Not staying in seat (café)

• Changing Centers

• Getting Water (not asking)

• Off Rest Mat and on and on

Precise Behavioral Descriptions

• How many categories can you reduce the previous list of behaviors to?

• Thoughts and suggestions:

Summary Statements

• This is where you develop your hypothesis.

• Get staff and other stakeholders thinking about function of behavior not topography.

Form Ever Follows Function

• List and describe the functions of the child’s behaviors.

• Escape, attention, access, sensory, etc.

• Finally, identify a plan!

Positive Behavioral Momentum

• Preferred Activities• Choices and Control• Positive Emotional

States• Positive Routine• Activity Engagement

and Completion

Positive Setting Events (Feeney, 2001)

• Environmental support• Choices• Positive routines• Positive emotional

states• Positive roles• Control• Preferred activities

Positive Setting Events (Feeney, 2001)

• Success with meaningful tasks tend to result in:– Activity engagement

– Completion of tasks

– Positive environment

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.

– Don’t say “no”, say “try again”.

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?”

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)

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.

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.

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.– “Grandma’s Rule”.– The “You could do

that . . .what will happen” Approach

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 didn’t help

• Guided• Self generated

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.

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 don’t get hurt - HE KEEPS HIS HANDS TO HIMSELF.

– Brett Farve follows the Coach’s directions.

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 Favre’s 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.

Managing Behavioral Crises

• Keep a “Stoneface”.• Redirection.• Active Listening &

Supportive Questioning– Ventilation

– Empathy

– Identification – Problem Solving

– Reflection• Manage the environment.

– General space.– Personal space.

Managing Crises (Some Don’ts)• Plant an idea for a

negative behavior.– “I know you’re mad

but, you better not . . .”

– “Don’t even think about . . .”

• Threaten with consequences.

– Creating confrontation.

– “I dare you.”– Creates negative

emotions.• Present commands as

questions.– “Would you like to?”

There is no magic!

• Hard work• Involvement of school

personnel, family and child

• Consistency• Commitment• Sense of humor

Thanks for your time!

• If you want to contact me: Try this way:

• [email protected] or 615-319-2473