INSTITUTE FOR APPLIED BEHAVIOR ANALYSIS POSITIVE PRACTICES - IABA

I N S T I T U T E F O R A P P L I E D B E H A V I O R A N A L Y S I S

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P O S I T I V EPR A C T I C E S

THE

N E W S L E T T E R

C o n t e n t s

Anger Management and AssertivenessSkills: Use of a Curriculum inSupported Living Services .................. 1

Editors’ Note ......................................... 2

Rug Rats, Videos and the Use ofEcological Strategies in the RapidReduction of a Severe andChallenging Behavior Problem ........... 3

The Use of Contingency Diagrams inthe Functional Analysis ofChallenging Behavior ........................ 17

Resources ........................................... 24

Continued on page 10

A quarterly publication dedicated to the advancement of positive practices in the field of challenging behavior

Volume III • Number 3 ISSN 1083-6187 • April 1998

Anger Management and AssertivenessSkills: Use of a Curriculum in SupportedLiving ServicesWilliam McLain, Tri-Counties Regional Center, Santa Barbara, CaliforniaEllen Lewis, Institute for Applied Behavior Analysis, Los Angeles, California

Editors’ Note: We are pleased to present this article by Bill McClain and EllenLewis describing an approach to anger management training for our IABAconsumers receiving supported living services. Gary had an opportunity to attendone of these sessions on one of his field visits and was totally caught up in theprocess, as well as being very impressed in how the process engaged everybodywho attended. Let us know if you would like more articles describing differentaspects of our services.

IntroductionFor the past few years staff at the Institute for Applied Behavior

Analysis (IABA) in Ventura County, California have been facilitat-

ing “stress management” groups as part of supported living services

(also known as Social and Community Integration and Participation,

or SCIP) with adults who have developmental disabilities. These

groups started as a variation of Personal Effectiveness Training

(PET) (King, Liberman, Roberts & Bryan, 1977) sessions, which

had been held regularly. It was observed that participants and staff

were generally unmotivated to attend the PET groups. At the same

time, many of the people participating in SCIP continued to demon-

strate poor impulse control, aggression, explosiveness, and diffi-

culty managing the stressors encountered while living and working

in the community.

The first group started as anhour-long weekly session withthree or four participants, one groupleader and one or two support staff.Additional groups were started inother areas of the community be-cause more people wanted to par-ticipate when they heard about orvisited the original group. Inter-ested staff persons were trained torun the groups. One group becamequite large (seven to ten regularparticipants) due to the convenientlocation and effectiveness of thegroup dynamics. Locations werevaried when possible in order tofacilitate accessibility for as manypeople as possible.

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P O S I T I V E P R A C T I C E S • V O L U M E I I I • N U M B E R 3 • A P R I L 1 9 9 8

Positive Practices

PublisherInstitute for Applied Behavior Analysis

A Psychological Corporation

Co-EditorsGary W. LaVigna and Thomas J. Willis

Managing EditorJohn Q. Marshall, Jr.

Institute for Applied Behavior AnalysisGary W. LaVigna, PhD, Clinical DirectorThomas J. Willis, PhD, Assoc. Director

Service to Employ PeopleLeeAnn Christian, PhD

Director of Supported EmploymentStacy L. Daniels, MA

Asst. Director Supported EmploymentSusan Caraway

Manager - Los AngelesAyndrea LaVigna

Manager - Ventura CountySteve Easler

Manager - North Los AngelesLinda Callaghan

Manager - Orange County

Social/Community Integration andParticipation

Maryam Abedi, PhDDirector of Supported Living

Leilah SaddManager - North Los Angeles

Kerry CostelloActing Manager - Ventura County

Lori LeakSupervisor - Ventura County

Cheryl Stroll-Reisler, MAManager - Los Angeles

IABA - GeorgiaDiane Sabiston, MEd

Senior Manager - Georgia

Professional Training ServicesJohn Q. Marshall, Jr., MEd

Director of Professional Training ServicesSouth Carolina

AdministrationRobert H. Shelton

Director of Administrative Services

Copyright 1998 by:Institute for Applied Behavior Analysis

5777 West Century Blvd. #675Los Angeles, CA 90045 USA

(310) 649-0499

All rights reserved. No portion of this newslettermay be reproduced by any means without theexpress written permission of the Institute for

Applied Behavior Analysis.

Positive Practices (ISSN 1083-6187) is aquarterly publication of the Institute for AppliedBehavior Analysis. Individual issues are $10.00

each. Subscriptions are $25.00 per year fordelivery within the US and $40.00 per year fordelivery outside of the US. For subscription

information, change of address or information onclassified advertisements contact: John Marshall;IABA; PO Box 5743; Greenville, SC 29606-5743

USA; (864) 271-4161.

Individuals wishing to contribute articles orletters to the publication are requested to contact

Gary LaVigna or Thomas Willis; IABA; 5777West Century Blvd. #675; Los Angeles, CA

90045 USA; (310) 649-0499. Contributions mayalso be submitted via our web site:

http://www.iaba.com.

Editors’ Note…This year is turning out to be a busy one for us. We are fortunate to be

engaged in a major, two-year training and consultation project in NewZealand. This is with Specialist Edu-cation Services, who are adopting ourmultielement behavioral model aswell as the Periodic Service Reviewas part of their quality improvementsystem, and a number of adult serviceagencies as well. In addition, we arepreparing for our regularly scheduledseries of training programs in theUnited Kingdom this fall. We arevery pleased to announce that theIABA courses we are offering in theUK will be sponsored by the TizardCentre, University of Kent at Canter-bury. The Tizard Centre is unparal-leled in the role it has taken in advanc-ing positive practices in the field ofchallenging behavior in the UK so wefeel particularly honored to be spon-sored by them. Finally, we are prepar-ing for our Second IABA Interna-tional Conference to Promote Posi-tive Practices in the Field of Challenging Behavior. The conference willbe in Orlando, Florida in January, 1999. We hope to see many of you there.

This issue of Positive Practices has three article. One has to do withthe provision of social skills training within the context of supportedliving services. This article was co-written by Ellen Lewis of our staff atIABA and Bill McLain of Tri-Coun-ties Regional Center. The second ar-ticle is co-authored by Mick Pitchfordwho has published previously in Posi-tive Practices. Mick and his col-leagues report the use of videotape intheir efforts to understand and solvethe problems of a student. They dem-onstrate a good example of where atime consuming assessment was notnecessary. Finally, Peter Baker in hisarticle describes a graphic means ofdisplaying the results of a complexanalysis to staff. We hope that youenjoy this quarter’s issue.

Gary W. LaVigna andThomas J. Willis, Co-editors

Gary W. LaVigna, PhDClinical Director

Thomas J. Willis, PhDAssociate Director


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Rug Rats, Videos and the Use ofEcological Strategies in the RapidReduction of a Severe and ChallengingBehavior Problem

Fiona Skinner, St. Andrews School, Derby, United KingdomHilary George, St. Andrews School, Derby, United KingdomMick Pitchford, Derby City Educational Psychology Service, Derby, UnitedKingdom

Editors’ Note: We are the first to recognize that the resources do not exist to carryout a full behavioral assessment and functional analysis for every person who isreferred for problem behavior. School systems in particular may assign caseloadsto its psychologists and others with the responsibility that would preclude this timeconsuming process for every student. Rather, we say, the full assessment andfunctional analysis should be carried out, among other criteria, for those people forwhom less time consuming efforts have failed.

In this article, Fiona Skinner, Hilary George and Mick Pitchford describe the useof videotape to facilitate the process of assessment and analysis. They make such astrong case that one might consider videotaping not just as a more time efficientalternative to a full assessment but, in addition, a possible additional tool incarrying out a full assessment. What do you think?

IntroductionSusan was an unhappy 12-year-old girl with mild athetoid

cerebral palsy and severe learning difficulties who had recently

transferred to a new school and had started to cause major problems

to staff and children alike. Some of the reasons for Susan’s distress

were plain enough to see. The death of a grandparent, a neighbor, a

pet and the death of Princess Diana had a profoundly unsettling

effect on Susan as did the change of school. Susan’s distress

manifested itself in a number of ways but the one that we will

concentrate on most was her assaults on staff and peers. In addition

her lone parent mother reported major difficulties getting Susan to

school and her attendance was also poor, making it difficult to help

her settle happily into her new school or for her new teachers to get

to know her.

attempted grabs per minute. Stafffound these assaults particularlyhard to deal with emotionally be-cause of their very painful natureand just as importantly becauseSusan would often apparently smileat the same time as she was hurtingsomeone.

When asked how they couldguarantee the problem would hap-pen staff reported that a changefrom one classroom to the nextseemed to have this effect as didplacing demands on her. Theyadded; “If you just let her sit and donothing in her place all day you’dhave no trouble with her.”

Because of the urgency of thesituation and the fact that the edu-cational psychologist would not beable to do a full behavioral assess-ment and functional analysis(Willis & LaVigna, 1996 a; b) be-cause of other local authority du-ties, it was decided to collect videodata (with parental consent) as away of accelerating the assessmentprocess. A total of just under anhour’s worth of video recordingwas collected on Susan in the spaceof one morning, some of it in herown classroom and some of it inthe art room. There are ethical is-sues surrounding the use of videorecordings and these will be dealtwith in a later section but the videorecording, together with a reviewof written records and interviewswith staff, was instrumental inachieving a very rapid reduction ingrabbing and pinching to the ben-efit of all those involved.

A Means to an EndThe first section of video sees

Susan sitting on her own appar-

Typically assaults constitutedgrabbing or pinching to otherpeoples’ arms, necks and breasts.

These assaults could occur singlybut often formed extended episodesinvolving as many as five grabs or

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ently quite happily. She is sat apart from the rest of thegroup of children on the advice of the educationalpsychologist so that it is more difficult for her to grabanyone. The situation gradually changes as the groupgets ready to move to another classroom. As a childwalks behind Susan she starts to look uneasy, twistingaround in her chair to look at the people walkingbehind her. Her change of expression is fleeting, thesort of thing an observer could well miss, but with thefacility a VCR has for repeated replays, quite clear andstriking. As students walk past her to leave the class-room Susan looks increasingly tense and grabs atsome of the children. For their part some of thechildren hold out their arms as though taunting Susan.Again, very fleeting behaviors which could easily bemissed by an observer (especially if they are using atime sampling approach) but using the replay optionvery telling.

The next section of the video recording showsSusan in the art room where she is between twomembers of staff who are sat on either side of her to tryand prevent her pinching any of the children. They dothis because for Susan to play any meaningful part inthe lesson she needs to be a part of the group. Conse-quently Susan is on a stool sat with the group ofchildren, as the lesson progresses Susan’s behaviordeteriorates very sharply. In the space of a little underseven minutes there are at least a total of 33 actual orattempted grabs. It is decided that Susan’s behavior isso bad that she should be taken back to her classroom.Susan immediately calms down and stops grabbing asshe returns to the classroom.

The third section of the video shows the educa-tional psychologist talking to Susan and working withher on progressive relaxation. However, before thisstarts she is asked where she wants to sit; she is veryemphatic about sitting with her back to the wall andwith the table in front of her to act as a barrier.

With this video in the can, so to speak, our initialhypothesis was that Susan was insecure, probablysuffering from separation anxiety and grief; foundchanges of room aversive and would therefore benefitfrom a corner of the classroom which she couldidentify as her own. For reasons we didn’t fullyunderstand she clearly liked to sit with her back to thewall. We therefore determined to make a part of theclassroom as homely for her as possible, hanging a

cloth on the wall, placing her chair against the wall ina corner with her own table in front of her. Susan wasalso told that she could bring two soft toys into schoolwith her and these could sit on a chair next to her in herhome corner. She chose a rug rat and a gorilla: in moreformal terms the presence of these toys could be seenas an ecological manipulation since it improved herenvironment by increasing non-contingent reinforce-ment (commonly known as fun). It was first thoughtthat we would have to reconcile ourselves in the shortterm to Susan spending most of her time in her “homecorner” while she gradually settled into her new schooland a program of desensitization to movement aroundthe school was started.

The use of videotape accelerated the pace of assess-ment so that we could start to implement a partialtreatment plan, which included only ecological strat-egies and reactive strategies, the day after recordingshad been completed. The impact on Susan’s behaviorof these purely ecological strategies was immediateand dramatic in foreseen and unforeseen ways. Notonly did her rate of grabbing and pinching fall to muchlower levels as from the first day of implementation — asthe chart depicted in Figure 1 reveals — her attendancerate also improved from an average of 45% to 79%.

What was unexpected was her greatly increasedwillingness to leave her classroom. Providing shecould take Tommy the Rug Rat with her she would goto other classrooms without the sorts of intense epi-sodes of grabbing and pinching which had been afeature of her behavior previously. We decided to

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Pre-Treatment Post-Treatment

Figure 1 - Effects of Ecological and Reactive Strategies onGrabbing

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Daily Average Grabbing

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shelve for the time being our previous plans to desen-sitize Susan to moving around the school. Whenproblems did occur they tended to be at more unstruc-tured times, for example in the corridors, in the schoolhall during lunchtime, in the playground. If problemsoccurred Susan would be told to go to her home cornerwhich she was always pleased to do and this consti-tuted our reactive strategy.

In the light of the experience gained and the infor-mation on videotape the educational psychologistagain reviewed the file and talked to Susan’s mother.At this point a highly significant piece of evidencecame to light which completed the jigsaw. As a toddlerlearning to walk Susan had to overcome the problemscaused by her cerebral palsy. In particular she hadoften had very painful falls because of her tendency tostartle in response to sudden noises behind her (par-ticularly sneezes) and topple over backwards. Herlack of saving reflexes exacerbated the situation andmeant that what would have been no more than asudden bump for most toddlers was experienced as atraumatic, painful and potentially dangerous loss ofbalance and control. Susan had eventually learned tosave herself by reaching out sideways and grabbingthe first thing she could as hard as she could. Susan nolonger falls over backwards in response to loudnoises but her early experiences will have consti-tuted prolonged and intense conditioning thelong-term effects of which we were beginning tounderstand.

With this knowledge we could again look atthe videotape. Now the reason for Susan’s tense-ness when someone passed behind her was com-pletely understandable, someone behind her mightmean a loud startling noise, loss of balance andpain. The episode in the art room now appeared in anew light, we had inadvertently placed Susan in anightmare situation, perched on a high stool with noback support and with people moving around behindher. In these circumstances, no longer was it surprisingthat she would grab, in ways she had learned as atoddler made her secure, it might even begin to explainthe grin that staff found so irritating. Maybe, Susanwas trying to communicate that she wanted someoneto be her friend and help her out of this situation.

In the light of the mother’s testimony and the cluesgiven us on video it also became clear that one of the

children knew very well from his long experience ofSusan in their previous school that he could tease andprovoke her if he made sudden noises behind her. Wethink this has contributed to Susan’s aversion of hav-ing children sit next to her - another antecedent we hadfound to grabbing and pinching.

The striking thing so early in the treatment programis the impact on Susan’s behavior of such simpleecological and reactive strategies alone. Susan is clearlya much happier girl, her attendance has improved andshe now routinely leaves her own classroom in waysthat seemed impossible only weeks before. Muchremains to be done but there is no doubt that Susan’squality of life has improved greatly. Presently a mul-tielement treatment plan (LaVigna & Willis, 1995) forSusan is evolving which amongst others contains thefollowing elements that are pertinent to the presentdiscussion.

Ecological StrategiesThe main ecological strategy is the one already

discussed, the provision of a home corner for Susanwhere she feels safe from disturbance from noisesoccurring behind her. The provision of the two softtoys could also be seen as an ecological strategy since

it greatly increased the availability of non-contingentreinforcement in her environment.

Positive ProgrammingSusan is being taught the use of an assertive state-

ment, “Please give me more space,” to serve theequivalent function for pinching and grabbing whenshe feels crowded.

We have begun progressive relaxation trainingwith Susan and will be preparing a tape of noise so thatshe can learn to tolerate sudden noises occurringbehind her. Given the probable strength of Susan’s

Maybe, Susan was trying tocommunicate that she wanted

someone to be her friend and help herout of this situation.

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conditioned response to these noises tolerance train-ing at meal times seems the best option. We will alsoneed to teach Susan problem solving routines to use insituations in which she feels uncomfortable or vulner-able so that she can escape these situations withouthurting people.

Direct Treatment StrategiesThe use of rewards to date has been relatively loose

and unstructured. Verbal praise with feedback is used

when Susan goes for periods without grabbing andpinching. Up until Christmas 1997 (the time of writ-ing) Susan was also working towards obtaining a“good video” showing her in a good light which shecould take home as a Christmas present providing theimprovement in her behavior was continued in thejudgement of her teacher.

Finally, given that an element in the problem ofpinching and grabbing is peer teasing, one possibilitywe will be exploring is a group contingency in order togive the rest of the class an investment in the situationimproving.

Reactive StrategiesThe reactive strategies used presently include the

reduction of demands and access to Susan’s home corner.

The Use of Video Recordings inFunctional Assessments

Although not a substitute for a full functionalassessment, the one hour video contributed very sig-nificantly to developing the depth of understandingthat is necessary if attempts to help them overcomesevere and challenging behavior are to be accuratelyand effectively focused. But there are very real ethical

issues to be considered and perhaps these should havepriority before going on to discuss the advantages.

It needs to be recognized that videotaping some-one, possibly when they are engaged in severe andchallenging behavior, has the potential to be verydemeaning. To undertake this sort of work there needsto be consent on the part of the child’s parents and aclear case that the urgency of the situation warrantsthis step (both conditions were met in our view inSusan’s case). How the issue of consent would be

handled with adult clients is an area weare not competent to judge and leave toour colleagues in services for adults toconsider.

Thought also needs to be given towhether or not the subject of the videoshould watch if it includes shots of theirsevere and challenging behavior. Ourview is that this should not happen inany circumstances. It seems to us that

the person will either find watching their own chal-lenging behavior aversive (which automatically pre-cludes its use) or rewarding (which is not desirable forobvious reasons).

Although we tried to maintain the fiction that wewere videotaping the class as a whole, the childrensoon realized that the focus of recordings was in factSusan. Therefore some time was spent recording thechildren and letting them view a video of themselves.They were also actively involved in the recording ofSusan’s “good video” looking through the cameraviewfinder, sitting next to Susan and taking part in roleplays where she uses the assertive statements we wereteaching her. Clearly then the impact that videotapingmay have on others present in the person’s environ-ment needs to be considered.

One area, which needs to be treated very carefully,is the issue of staff expectations regarding videorecordings. There are two points here: the first is thatit needs to be emphasized to staff that they are notexpected to provoke severe and challenging behaviordeliberately so that it can be videotaped. If they are ina position to do this then videotaping is partly redun-dant as we can find out from a conventional interviewwhat the antecedent conditions for severe and chal-lenging behavior are. The second point is that if severeand challenging behavior does occur they should do

there are very real ethical issues to beconsidered and perhaps these should havepriority before going on to discuss theadvantages.


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whatever they think best and would normally do tomake the situation safe as soon as possible. Withoutthis injunction staff, in our experience, have a ten-dency to let the situation run longer than they normallywould as they think it will be helpful to the psycholo-gist to get as much on video as possible. Consequentlythe fact that safety has an absolute priority over every-thing has to be emphasized to all of the staff involved.

Staff feelings need to be addressed particularly if itbecomes clear from the video recordings that theirbehavior is inadvertently contributing to problems.Experiencing severe and challenging behavior is stress-ful enough without the added stress of being caught onvideo as you struggle to cope with the situation. It isperhaps significant in this respect that the staff in-volved with Susan on a daily basis expressed greatsatisfaction (shouts of laughter) when the psycholo-gist is seen on video getting pinched and grabbed aswell as just the regular staff. Clearly trust and mutualrespect will make this process a lot easier. If it is anoutsider such as a psychologist who is involved indoing the recording then we would suggest they getinvolved in the activities being videotaped and be-come a participant rather than “director.” Ridingbreaches, horsewhip and megaphone are definitelynot required.

Other Issues That Need to be Thought About in AdvanceWhose property is the video recording? If the

recording is deemed comparable to file notes, whatmeasures will be taken to store and then destroy itwhen the person becomes an adult? If consent (includ-ing staff consent) is obtained for using thevideo for training purposes who will andwill not be allowed to see it?

So far we have concentrated on the prob-lems of videotaping and the safeguards andissues which need to be decided upon. How-ever, there are very real advantages to begained from this technology and we will tryto give some flavor of these by using illus-trations from this and other casework.

Staff TrainingThe power of video to reveal during assessment the

stimulus conditions for the occurrence and non-occur-rence of problem behaviors in assessment also gives it

great power as a training tool.One child we recently worked with had a history of

severe assaults and non-compliance. In the video wetook of her she is given instructions on two occasions.On one occasion she responds happily on the secondshe tantrums. The key to her tantrums was the way inwhich tasks were introduced to her. If the adult placedtheir face close to Tracey’s and used the sort of tone ofvoice a playful parent would to a baby or toddler, e.g.“Trraaaccceeeyyy, who’s a lovely girl?....you are....yesyou are.....yyyyyessss youuu are! Look what I’ve gotfor you (showing Tracey her tray of work)....’..ThenTracey would show every sign of pleasure and complywith adult requests framed and delivered in this way.If, on the other hand, the adult used a stereotypical andentirely reasonable teacher approach—”Tracey goand sit at the table. It’s time to do your work”—asevere and intense tantrum, which might escalate intoassault, occurred within four seconds of the instruc-tion being given. Being able to show staff how to andhow not to give instructions to a particular child can beinvaluable, particularly when, without the sort of vividevidence only video can provide, staff could be for-given for being reluctant to put their face close to theface of someone with a history of assaults.

The Video Allows Calm Reflection of the Child’s BehaviorObserving children in situations where they and the

staff who support them are under stress is in itselfstressful and so it is very easy to miss or fail tounderstand the significance of events. For example, inthe present case, the educational psychologist and

other staff were often on tender hooks trying to ob-serve and contribute to making the situation safe witha student who was very volatile. At the end of thevideotaping session the educational psychologist hada “feeling” that Susan’s peers were sometimes teasing

Experiencing severe and challengingbehavior is stressful enough without theadded stress of being caught on video asyou struggle to cope with the situation.

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her although he could not say why he thought this. Itwas only when he viewed the videotape away fromdistractions that he realized this “feeling” was basedon an incident that lasted for three seconds on thevideotape. Presumably he had glimpsed the situationbut it had not fully registered because of the combina-tion of stress and the large number of distractionsinevitably present in a busy classroom.

The Videotape Allows the Repeated Viewing of CriticalIncidents

Some of the behavior we observe is not only severeand challenging it is also complex and easily misinter-preted - the ability to viewthe same critical incident re-peatedly and in juxtaposi-tion with other incidents canbe invaluable. In the case ofTracey this was fundamen-tal in understanding the func-tion of some of the behaviorwhich constituted a part of acomplex chain of tantrumbehavior. One of Tracey’sfavorite activities was tick-ling games. Because she has no functional languageher way of communicating this was to grab someone’shands and place them on her tummy. During tantrumbehavior in response to instructions Tracey would runaround the room, beat the floor with her hands, scream,grab adults” hands and pull them towards her and thensometimes bite her own hands or the teacher’s hands.It had always been assumed that when Tracey waspulling someone in this way it was because she wantedto bite them. With repeated viewing of the video andby juxtaposing the videotaped tantrum behavior withthat of Tracey “requesting” a tickling by pullingsomeone’s hands, a new interpretation of her tantrumbehavior emerged. The message value of which was—“I don’t want to do x but I would like a ticklinggame...if you carry on trying to pull away from me andso not listen to me I’ll get so frustrated I will bitemyself or maybe even you.” This is quite a differentmessage to the one we had assumed Tracey was givingduring these episodes, which was—“I don’t want to doanything and I’ll bite you if you try to make me.” Thisinsight enabled us to start working on ways of de-

escalating tantrums when they did occur as staff realizedthey could respond to Tracey grabbing them by, in effect,saying, “Okay what do you want? Show me.” Therebyreducing the risk of Tracey biting herself or others.

Viewing the Videotape on Fast Forward Can be VeryRevealing

For many years city planners have realized thatviewing videotape on fast forward dramatically high-lights traffic flows and bottlenecks. The same holdstrue for classrooms. It can also reveal very quicklywhich children are never in their seats, which childrennever leave their seats, which children get high rates of

teacher proximity andwhich children get low ratesof teacher proximity. It canhighlight “down time”when there is nothing forthe child to do. As a preludeto data collection using avideotape the educationalpsychologist always viewsthe tape on fast forward firstbecause of clues this giveson which particular behav-

iors or situations should be focused on in detail for datacollection.

Videotape is a Potent and Underused Quality AssuranceTool

In a previous study the educational psychologistwas involved in videotaping a teacher while a RulesPraise Ignoring (RPI) approach was used togetherwith a group contingency using differential reinforce-ment of low rates of responding (DRL) in order to helpa highly challenging class of 15-year-olds (Frankland,Pitchford & Pitchford, 1985). In the course of threeweeks dramatic improvements were obtained whichwere maintained two months after the DRL was fadedout. It was only some months later that the educationalpsychologist realized that what was remarkable aboutthis particular video was not the improvement in theclasses behavior (gratifying though that was) so muchas what might be termed the teacher’s 100% compli-ance with the methodology recommended by the edu-cational psychologist. Anyone who works in the fieldof advising staff will know that such a very high level

…the ability to view thesame critical incident

repeatedly and injuxtaposition with other

incidents can be invaluable.


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of compliance is, well, unusual. Although the educa-tional psychologist concerned would like to ascribethis phenomenon to charisma, it seems more likelythat the process of agreeing to and being videotapedwas the most significant factor.

This is what was happening; the educational psy-chologist would give the teacher briefing notes con-taining a rationale for and description of the tech-niques to be used before each of the four lessonsvideotaped. They would then be discussed, modeledand clarified if necessary. The lesson would be video-taped and then the teacher, not the psychologist, wouldtake the video to view it before the next session; theeducational psychologistonly looked at the video indetail at the end of the projectin order to collect data. Thecombination of notes, dis-cussion, modeling and ex-planation, followed by anopportunity to practice andget extremely vivid confi-dential feedback on theteacher’s own performance and its impact on the classseems to have led to this high level of compliance.

In his discussion notes about the experience later,the teacher noted that the video was crucial in helpinghim come to terms with the fact that a high rate ofpraise did not seem artificial as he had feared it would.It seems likely that without this video feedback hewould have found it difficult to maintain the high ratesof praise required. What struck the educational psy-chologist was that even incidental “off the cuff” com-ments could be seen to have had an impact on theteacher’s behavior. At one point the psychologistmade the comment that simply pointing to some workand saying, “That’s right,” could be considered aspraise (or more accurately feedback) and so wouldtend to increase time on task. No more was said on thematter and it was not included in the written notes.Nevertheless, in the next video after this discussion,the teacher can be seen walking down the rows ofdesks going: “That’s right, good, that’s right. GoodSteve, you got that right. That’s right Anne. That’sright.” Given the right climate of trust and respect it isclear that using the video camera as a means ofproviding feedback as part of training could lead to

very real improvements in expertise and quality. Itsimpact in conjunction with three-tier training (LaVigna,Willis, Shaull, Abedi & Sweitzer, 1994) would be aparticularly interesting area to explore.

Being videotaped is very rewarding to children andenables them to model and get feedback on alternativeways of behaving

A good example of the way in which video can beused as a teaching aid with children is the work ofEdwards and Prouxl (1997) where they report the useof edited videotape in the treatment of selective mut-ism so that the child could watch herself engaged in

speaking. They report thatthis strategy produced rapidand lasting change in thechild concerned.

In our own more modestway we included in Susan’sgood video shots of her roleplaying one of the func-tional equivalents for grab-bing, asking people to leave

her table because she felt crowded. In our view if videois used to collect data on a child, then one way ofmaking recompense for this intrusion would be theproduction of a “good video,” which then becomes thechild’s property.

ConclusionTo conclude, the video camera has great potential

in our field and it is surprising how rarely it is used forthe purposes of data collection, analysis, training andquality assurance. In areas associated with security thevideo camera is becoming ubiquitous, perhaps there-fore now is the time to come up with a code of practiceon its use before somebody decides to do it for us. If acode of practice is developed then it will have toreconcile the power the video camera has with theneed to protect the dignity and confidentiality of thosewe seek to serve.

Footnote: Fiona Skinner is an Education Care Of-ficer, Hillary George is a Teacher at St. AndrewsSchool in Derby, U.K. Mick Pitchford is the PrincipalEducational Psychologist for Derby City EducationalPsychology Services, Derby, U.K.

…without this videofeedback he would have found

it difficult to maintain thehigh rates of praise required.

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The groups utilize the framework of an angermanagement curriculum originally developed for usethrough Tri-Counties Regional Center, based in SantaBarbara, California. Subsequent to its developmentand use with adults in the Santa Barbara area, thecurriculum was adapted for use and piloted withschool-age students in a special education classroom(see McLain & Lewis, 1994). This guideline andcurriculum for an instructional group was originallydeveloped to assist individuals with developmentaldisabilities who have difficulty controlling their angerin their home, work, school or community environ-ments. It was an outgrowth of the behavior interven-tion efforts at Tri-Counties Regional Center to assistpersons to remain in community living arrangements,to integrate physically and socially into the commu-nity, and to obtain and maintain employment.

Since being implemented within the context ofsupported living services at IABA, the curriculum hasbeen modified to fit the needs of many differentindividuals, and has evolved from a relatively short-term program into a long-term skill acquisition, skillmaintenance and support group. The use of the cur-riculum has also provided fertile ground for groupmembers to develop supportive relationships that havepersisted outside of the group environment.

While developing supports for individuals who

have difficulty controlling their anger, it became ap-parent that most of the research literature on teachinganger management skills was addressed to personswithout developmental disabilities (e.g., Hains &Szyjakowski, 1990; Glick & Goldstein, 1987). Thiscurriculum represents an effort to utilize the approacheswhich have appeared most promising for all popula-tions, adapt them for use by persons with varyingdegrees of cognitive disabilities, and present them ina flexible group format that can be adjusted to theparticipants’ abilities and learning style.

The concepts are based upon behavioral and cogni-tive behavioral frameworks and incorporate the workof Novaco’s Stress Inoculation Therapy (1977),Kaufmann and Wagner’s Systematic Treatment Tech-nology for Temper Control Disorders (1972), Benson’s(1986) approach to self-instructional training and prob-lem-solving skills, as well as Personal EffectivenessTraining described by King, Liberman, Roberts, andBryan (1977). In addition, the curriculum addressesarousal management through relaxation training, rec-ognition of internal and external cues to manageanger, demonstration and practice of problem solvingskills and self-instructional training. This program isan eclectic blend of various anger management strat-egies. The approach has been successfully used withchildren, adolescents, and adults who possess thefollowing prerequisite skills:

1. The ability to attend in a small group setting(4 - 8 participants) for at least fifteen minutes ata time.

2. The ability to receptively and expressively com-municate verbally, with signs or pictures orthrough a communication device.

The curriculum is designed to be modified to fit thespecific needs and abilities of the group members. Forexample, when presenting the program to a group ofadolescents who have mild disabilities and who areable to read and write, the focus should be on changingthe internal thoughts that precede an anger outburst.Written homework exercises would also be usefulwith such a group. A group of children who havemoderate disabilities and limited abilities to read andwrite would benefit from an emphasis on role playingand behavior rehearsal of appropriate behavior fol-lowing exposure to provoking situations. The cogni-tive-behavioral aspects of the program may be simpli-

Continued from page 1

References

Edwards, T. M., & Prouxl, G. A. (1997). The use of edited videos forthe treatment of selective mutism. Positive Practices, II (4), 3-7.

Frankland, S., Pitchford, Y. M., & Pitchford, M. (1985). The use ofvideo recording to provide repeated monitoring of the successful useof “rules, praise, ignoring” with a class of 14-15 year olds in acomprehensive school. Behavioral Approaches with Children, 9, 3,67-78.

LaVigna, G. W., & Willis, T. J. (1995). Challenging behavior: A modelfor breaking the barriers to social and community integration.Positive Practices, I (1), 1, 8-15.

LaVigna, G. W., Willis, T. J., Shaull, J. F., Abedi, M., & Sweitzer, M.S. (1994). The periodic service review: A total quality assurancesystem for human services and education. Baltimore: Paul H. BrookesPublishing Co.

Willis, T. J., & LaVigna, G. W. (1996a). Behavioral assessment: Anoverview. Positive Practices, I, (2), 1, 8-15.

Willis, T. J., & LaVigna, G. W. (1996b). Behavioral assessment: Anoverview – Part 2. Positive Practices, I, (3), 1, 11-19.

Willis, T. J., LaVigna, G. W., & Donnellan, A. M. (1993). BehaviorAssessment Guide . Los Angeles: Institute of Applied BehaviorAnalysis.


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To achieve (generalization) it isessential to include persons from

each participant’s naturalenvironments in the program.

fied in order to suit the children’s cognitive abilities.For people with severe disabilities, a focus on relax-ation training and a specific, prescribed plan for re-sponding in challenging situations may be most ben-eficial.

The effective and consistent use of learned angermanagement skills is, like many other skills, depen-dent upon the individual’s retention, application andgeneralization of these skills in natural environments.It has long been documented in the behavior analysisliterature (e.g., Wahler, 1969) that persons with devel-opmental disabilities have difficulty generalizing newlylearned behavior across environments. To reduce theproblems associated with failure to generalize, thisanger management curriculum is designed with spe-cial attention to promoting, shaping, and generalizingself-control and problem-solving skills from simu-lated to natural environments.

One of the most effective strategies for promotinggeneralization involves planned training and expo-sure to the naturally occurring contingencies in thenatural environment (Stokes & Baer, 1977). To achievethis end it is essential to include persons from eachparticipant’s natural environments in the program.These social agents are enlisted to assist in cueingindividuals to frequently practice newly learned skills,and most importantly, to reinforce and support indi-viduals when they spontaneously use these skills un-der naturally occurring provocations. This works verywell when the group participants are also serviceparticipants and group facilitators have access toand regular communication with support staff,peers and families.

Facilitation of generalization and maintenanceis a primary reason that training is done in a grouprather than individual context, although specificgroup members often benefit from “booster” ses-sions, which could be done individually or indyads. When anger management and assertivenessskills training is done in a group context, members areprovided with opportunities to practice self-controland appropriate responses to others with whom theytypically interact on a regular basis. The leadership ofthe group by a staff person and attendance at groupsessions by support staff as well as roommates andacquaintances increases the likelihood of opportuni-ties to reinforce and shape desired behavior outside of

the group. Regular communication with additionalinvolved service providers and families provides afoundation for generalization and maintenance.

Forming the GroupIt is usually not difficult to identify the people who

may benefit from participation in an anger manage-ment group. These are people who, in a school, workor living environment, are identified by peers, teach-ers, support staff, school psychologists, counselors,job coaches, parents, case managers (i.e. key socialagents) as having trouble controlling their anger. Ad-ditionally, these are people who may have alreadybeen referred for the development of a behavior as-sessment and support plan. Persons appropriate forthis group evidence verbal and/or physical aggressionto the point that these behaviors interfere with theperson’s achievement of personal goals or their abilityto function or remain in regular environments. Forsome people, behavior challenges emerge as theyadjust to major life changes. There are a number ofstressors that people who are new to living in commu-nity settings may be experiencing for the first time.People’s coping abilities may be challenged by theseexperiences (for example, the difficulty of survivingon a poverty-level income or the challenge of startinga new job).

When forming the anger management group, an

individual could be invited to participate by findingout whether or not they are satisfied with the way theirday-to-day life and/or personal relationships are go-ing. Suggesting that the individual participate in thegroup because they have an anger problem may provean unsuccessful strategy. This is one of the reasonsthat the groups that operate in Ventura County arecalled “stress management” groups rather than “anger

12


The key social agents can promotegeneralization and support theindividual’s efforts to improve self-control by recognizing and reinforcing theskills that are taught in the group.

management” groups. A positive approach is to intro-duce participation in the group as a way for the personto more effectively get the things they want, have morefriends, have access to desired activities, and also as anopportunity to discuss stressful situations as theyoccur. Exploration of the individual’s short-term and

long-term goals is a way to accomplish this.It is essential that the people who most frequently

interact with the group participant support the workthat is done in the group. Key social agents can do thisby providing information, communicating with theparticipants about their progress, providing subtleprompts in natural settings, collecting data on behav-iors targeted in the teaching sessions, and participat-ing in sessions as requested by the group leader. Thekey social agents can promote generalization andsupport the individual’s efforts to improve self-con-trol by recognizing and reinforcing the skills that aretaught in the group. Group participants are encour-aged to share their progress with key social agents.These persons must be kept informed on a regularbasis by the group leader about how to support theanger control plan and about individual progress.Therefore, it is necessary to secure, preferably inwriting, the permission of the participant to contactfamily members or people outside of the supportsystem on a regular basis. The formal curriculumincludes suggestions for what information should becommunicated each week to these people.

Certainly, people with developmental disabilitiespresent with a wide range of verbal, reading, socialand cognitive abilities. In addition, a number of theadults participating in community based servicesthrough IABA also experience symptoms of variousforms of mental illness such as depression, schizo-

phrenia and manic-depression. It is therefore neces-sary to adapt this curriculum for individuals depend-ing on their abilities to process and retain informationand monitor and reflect on their own thought pro-cesses. For people who have difficulty with the cogni-tive aspects of the curriculum, instruction should

focus on behavioral approaches of devel-oping and rehearsing problem solving skillsas alternatives to temper outbursts. Forpersons who do not read, pictures or a taperecorder may be used during training in avariety of ways (e.g., flow charts, self-monitoring procedures).

The curriculum may be presented ef-fectively with one or two people in leader-ship roles. With two leaders it is possibleto do a large group presentation of thesession topic, then break into smaller

groups for discussion and practice of individualizedapplication of the material. The use of two leadersprovides the participants with greater opportunities topractice the target behaviors, identify individual prob-lem situations, and allows more time for questions anddiscussion of the material. If two leaders are used, theyshould have a solid understanding of the material to bepresented and be in regular communication regardingindividual participant progress. If a small group for-mat is used, the members of the small groups should bevaried from session to session in order to facilitategeneralization across individuals.

Assessment and Progress MonitoringPrior to participation in an anger management

group utilizing these guidelines, preliminary assess-ment information should be obtained in order to ap-propriately adapt the curriculum. Certain participantsmay become involved with the group as a recommen-dation of their behavior support plan, in which casebackground information should be found in the as-sessment. Some of the curriculum sessions demandhigher level cognitive skills than other sessions. It isessential that group leaders utilize ongoing as well aspreliminary assessment procedures to determinewhether the individual is able to encode, retain, ac-cess, and utilize the specific strategies taught throughthe exercises and most importantly, under naturally


13

The primary goal of training is to giveeach person the tools that they need to

effectively manage their anger…

occurring conditions. There are some guidelines forassessing the individual’s success in retaining andutilizing learned strategies provided in each session.

The preliminary assessment may include docu-mentation of the frequency, duration and intensity ofthe anger problems. If a behavior assessment has notbeen completed, prior to attendance at the first session,key social agents in all environments should collect atleast this basic information. One method for collectinginformation consists of an antecedent-behavior-con-sequence format. The key social agent observes theindividual’s behavior and documents the time andplace that the behavior occurred, the antecedent to thebehavior (what was happening in the environment justbefore the behavior occurred), and provides a detaileddescription of the observed behavior, including itsduration. An account of the events immediately fol-lowing the behavior (the consequences) should also benoted.

Brief interviews with participants and key socialagents can be used to obtain information about theindividual’s medical status, sleeping and eating pat-terns, means of communication, environment anddaily schedule with its concomitant demands. Infor-mation about activities and items that may motivatethe individual is important when developingan array of reinforcers for use during the pro-gram.

Overview of Training Sessions

Goals of the GroupThe primary goal of training is to give each person

the tools that they need to effectively manage theiranger. Inadequate anger management may result intemper outbursts, verbal or physical aggression, prop-erty destruction, self-injurious behavior, and a rangeof other individualized behaviors. In addition to otherfactors, these behaviors may occur in part because ofa person’s inadequate repertoire of non-aggressiveproblem solving skills or because of a lack of motiva-tion to engage in pro-social behavior. Many individu-als have learned that aggressive behaviors meet theirneeds for attention or help them escape or avoidundesirable activities. Many persons who have devel-opmental disabilities manifest poor impulse control

and simply are unable to interrupt an arousal responsein the face of provocation.

The curriculum includes skill training and practicein appropriate social skills (e.g., assertive behavior)and behaviors incompatible with aggressive behavior(e.g., relaxation) which have been demonstrated toeffectively replace inappropriate social behavior (e.g.,verbal or physical aggression). Through the cognitive-behavioral aspects of the program, individuals learn tointerrupt the chain of behaviors that may lead to lossof self-control. Improvements in self-control havebeen observed to lead to increases in positive self-concept, which may have an entire range of positiveeffects on a person’s quality of life.

Structure of SessionsThe sessions are divided into two parts. The first

portion of each session consists of a short presentationand discussion of a specific topic followed by exer-cises presented by the group leader to illustrate the useof the skill being taught during that session. Theexercises are an essential component of the session ifthe individual is to translate the information intopersonal practice, that is, adapt it for their own dailyuse in natural environments. Information presented to

the group is italicized and structured so that the leadercan give individuals information that is easy to under-stand and retain. Of course, it is often necessary torephrase, repeat, and in some cases, greatly simplifythe information to insure that it is understood.

The second portion of each group meeting is pre-sented in a format similar to Personal EffectivenessTraining (King et al., 1977). In a small group setting (itis useful to have two leaders here to allow for evensmaller groups) antecedent situations are presentedvia narration (to set up the situation) and role played(to present the identified antecedent) by the groupleader. The participant is coached through modelingand instruction in developing an appropriate alterna-

14


tive response as identified for that individual. If pos-sible, sessions should be videotaped, the best perfor-mances of the individual selected and repeatedly playedfor the individual, accompanied by comments on thebest aspects of the performance. This “self-as-a-model”approach (Hosford, 1976), is quite useful for youthwith developmental disabilities.

Outline of SessionsDuring sessions 1 and 2 the rationale for learning to

manage one’s anger is presented to increase motiva-tion and commitment to the process. Individuals arethen assisted with identifying individual behaviorpatterns and antecedents to temper outbursts that aretargeted during group or dyad role-play sessions. Theterm “antecedents” is replaced by the term “barbs”(from Kaufmann & Wagner, 1972) to simplify the idea.

Sessions 3 and 4 continue antecedent identificationand cover the fundamental skills required for angermanagement, namely, recognizing internal cues anddeveloping relaxation skills. Relaxation proceduresconsist of modified Jacobson (1938) ProgressiveMuscle Relaxation. The goal is to help each personidentify a deep state of muscle relaxation and produceit quickly in the natural environment. Session 5 fo-cuses on the physiological changes that should cueindividual’s self-regulatory behaviors. Session 6 re-views all previous material in order to help participantsintegrate it through review, exercises and instruction.

The advanced cognitive-behavioral aspects of tem-per control are explained in Session 7. Modificationsof the cognitive-behavioral treatments for personswith developmental disabilities have been exploredby some researchers (Benson, Rice, & Miranti, 1985).These modified treatment approaches are presentedand adjusted to fit the needs and abilities of each groupparticipant.

Basic assertiveness skills are taught in Session 8with a special emphasis on discriminating assertivefrom aggressive responses. Individuals begin to de-velop problem solving skills which help them todiscriminate which situations warrant assertive re-sponses, differentiate appropriate from inappropriaterequests from others and practice effective communi-cation skills.

Session 9 focuses on strategies for identify-ing and defining problems, generating behav-ioral alternatives, and evaluating the outcomeof those decisions. Part of this session focuseson the positive evaluation of outcomes andconstructive self-evaluation that promotes be-havior change and self-esteem enhancement.

Session 10 focuses on the more subtle aspectsof social skills involved with assertiveness re-sponses. Topics such as dealing with repeated

criticism, reinforcing others for desirable behaviors andcommunicating feelings without blaming are practiced.Making requests for behavior change from others isincorporated into a sequence of behaviors.

The final session (11) reviews all material and role-play situations. Individuals are encouraged to setpersonal goals and continue anger management strat-egies on their own.

Additional ConsiderationsThis outline can be modified to include additional

strategies or to extend the number of sessions fordifficult topics. There should be ongoing evaluation ofthe need for individual, topic-specific sessions toaugment the group sessions. Special modifications forpresentation of material to group members who, forexample, do not read, is the responsibility of the groupleader. The group leader should assess through ques-tions and role-plays, the amount of time needed forindividuals to master the material and extend thenumber of sessions per topic as needed. Individualsmay develop anger management strategies that do notfollow the exact skills presented here; the group leadershould allow this flexibility if the strategies are usefulfor the participant. It is the adjustment of the curricu-lum to meet individual needs, which contributes greatlyto its effectiveness, although this also necessitates acertain level of sensitivity and sophistication in thegroup leaders.

Individuals begin to develop problemsolving skills which help them todiscriminate which situations warrantassertive responses.


15

Initially group leaders may choose to create incen-tive systems to motivate individuals to attend sessionsand complete homework assignments. This can alsobe done in conjunction with key social agents. AtIABA, several people have protocols for attendingstress management sessions on a regular basis. Theirprotocols specify reinforcers that can be earned forachieving their attendance goals. Incentives may bearranged to occur in natural settings during and afterthe training period when key social agents observe anindividual using a strategy practiced in training. Groupmembers may reinforce each other as they see eachother use appropriate problem solving skills in naturalsettings. This is another reason for regular communi-cation with key social agents regarding the currenttraining topic and weekly goals of each person.

Once group members have been through the entirecurriculum, the framework can be used to work througheach week’s “barbs” on a regular basis. Often groupmembers can relate to another person’s “barb” and canprovide feedback from their own experience, furtherdeveloping an atmosphere of empathy as well asgenerating practical solutions to real-life problems.Soon the group members are taking more active,directive roles in the group and the leaders can movemore into the background.

Staff persons other than the group leaders should beencouraged to participate as groupmembers without dominating thegroup with tales of their own “barbs.”Staff persons can assist as models dur-ing relaxation and role-plays and canassist with keeping the group on track.A discrete amount of appropriate self-disclosure goes far in dispelling anysense of “us” (staff) vs. “them.” Par-ticipants have always seemed to ap-preciate it when staff persons open up.The stress management groups havealso taught support staff practical cop-ing skills for themselves as well as fostering futuregroup leaders and encouraging follow through outsideof the group environment.

For longer-term groups, the routine of the formatcan be broken up by taking “stress management fieldtrips” to relaxing settings, or by playing a social skillsgame such as the Ungame (Dobson). With the original

Ventura County group, participants had learned pro-gressive muscle relaxation and had moved to guidedimagery. During a guided imagery session, the leaderdescribed a waterfall and later learned that none of thegroup participants had ever seen a real waterfall. Afield trip was made to a waterfall, where group mem-bers were encouraged to use all of their senses toexperience the setting so that they could subsequentlycall upon their memories to achieve a relaxed state.

The use of the curriculum with adults in supportedliving has proven to be extremely effective and hasresulted in improved self-control and self-esteem forparticipants. Each group leader has brought their ownunique style and personality to the groups, resulting ina flexible approach with long-lasting results. Partici-pants have demonstrated their ability to learn the basicway to work through “barbs” even when they are notin the group setting. Support staff report improve-ments in their ability to manage challenging workloads as a result of participation in the groups.

The first session is included in Figure 1 (see page16) as an example.

As can be seen, the sessions are set up to engage theparticipants in the purpose of the work, let them knowthat they are not alone in experiencing such difficul-ties, and provide concrete direction for recognizingand addressing the impact of anger and loss of control

on their lives. The homework serves as a solid refer-ence point for the previous week’s session. The cur-riculum has been successfully used in a flexible man-ner, tailored to individual needs and specific groupdynamics. This requires a certain level of sensitivityon the part of group leaders. We have typically foundthat group leaders are excited by the curriculum and by

Often group members can relate to anotherperson’s “barb” and can provide feedback

from their own experience, furtherdeveloping an atmosphere of empathy aswell as generating practical solutions to

real-life problems.

16


SESSION 1: RATIONALE FOR TRAINING

WHY IS IT IMPORTANT TO LEARN TO CONTROL YOUR ANGER?

This discussion should focus on problems created by poor anger control. Discuss each of these facts withthe group.• When people lose their jobs it’s usually because they can’t get along with their boss or co-workers, not

because they can’t do the work.• If you hurt someone and the police are called the person you have hit may wish to press charges, which

can result in you having to go to court. If it has happened before, you may be asked to move to a differentplace. If you get really mad and are hurting people, you may have to go a special hospital called apsychiatric facility.

• You may lose friends or relationships. Your family may not want to spend time with you. People may notwant to be around you. This can be very lonely.

• You can lose your job and lose the chance to get a new job. If your boss fires you because you fight withothers, it may be hard to get another job.

• You may be kicked out of school for a few days (suspension), or be sent to a different school (expulsion)if you can’t get along with others around you.

• You may not be allowed to continue to ride a bus independently if you have problems with your temperwhile you are riding the bus. This cuts down on your independence.

• People who stay angry may get sick more often and may even die at a younger age. Getting angry is hardon your body.

• When you yell a lot or hit others you might have to move out of places where you like to live.• Most of you have decided you want to have a happier, better life by learning ways to control your anger

and solve problems better.

EXERCISES

Have individuals list and discuss events in their lives in each area that have been affected by their anger:• School • Jobs• Transportation • Relationships• Legal • Roommates• Friends • Family

HOMEWORK

List the things that happen this week that make you feel angry and write down or dictate how you handledthem. Use this format:

Date Time Situation What You Thought and Did1. __________ _______ ___________ __________________________________________2. __________ _______ ___________ __________________________________________

NOTES TO THE GROUP LEADER

Provide practice for the homework assignment in class by demonstrating from your personal life an eventyou might include on the worksheet. Have each individual complete at least one entry and assist asnecessary. Fade prompts so that the individual is able to demonstrate independent completion of an item.

Contact the key social agents in the participants’ home, school or work environments and share with themany pertinent information that came out of the first session. Give them information about the homeworkassignment, and ask them to provide social reinforcement to the group member following daily completionof the homework.

Figure 1 - Session 1: Rationale for Training


17

the progress of participants. It is adynamic process that allows a cre-ative approach.

Footnote: For additional infor-mation, or a complete copy of thecurriculum, please contact Dr. EllenLewis by writing to Positive Prac-tices, Institute for Applied Behav-ior Analysis; Attention: JohnMarshall; PO Box 5743;Greenville, SC 29606 USA.

References

Benson, B., Rice, C. J., & Miranti, S. V.(1985). Effects of anger managementtraining with mentally retarded adults ingroup treatment. Journal of Consulting andClinical Psychology, 55(4), 728-729.

Benson, B. (1986). Anger managementtraining. Psychiatric Aspects of MentalRetardation Reviews, 55, 51-55.

Glick, B., & Goldstein, A. P. (1987).Aggression replacement training. Journalof Counseling and Development, 65, 356-362.

Hains, A. A., & Szyjakowski, M. (1990). Acognitive stress-reduction interventionprogram for adolescents. Journal ofCounseling Psychology, 37(1), 79-84.

Hosford, R. (1980). Self-as-a-model: Acognitive social learning technique. TheCounseling Psychologist, 9, 45-62.

Jacobsen, E. (1938). Progressive relaxation.Chicago: University of Chicago Press.

Kaufmann, L., & Wagner, B. R. (1972).Systematic treatment technology for tempercontrol disorders. Behavior Therapy, 3(1),84-90.

King, L. W., Liberman, R. P., Roberts, J., &Bryan, E. (1977). Personal effectiveness:A structured therapy for improving socialand emotional skills. Behavioral Analysisand Modification, 2(1), 82-91.

McLain, W. & Lewis, E. (1994). Angermanagement and assertiveness skills: Aninstructional package for persons withdevelopmental disabilities. In M.F. Furlong& D. Smith (Eds.), Anger and CynicalHostility in Children and Adolescents:Assessment, Prevention, and TreatmentStrategies (pp. 473-507). Brandon,Vermont: Clinical Psychology PublishingCompany.

Novaco, R. W. (1977). Stress inoculation: acognitive therapy for anger and itsapplication to a case of depression. Journalof Consulting and Clinical Psychology,45(4), 600-608.

Stokes, T. F., & Baer, D. M. (1977). Animplicit technology of generalization.Journal of Applied Behavior Analysis, 10,349-367.

The Use of Contingency Diagrams in theFunctional Analysis of ChallengingBehaviorPeter A. Baker, Hastings & Rother NHS Trust/Tizard Centre, University of Kent atCanterbury, United Kingdom

Editors’ Note: In the following article, Peter Baker describes a method tocommunicate a complex understanding of challenging behavior to direct servicestaff. He rightfully points out that the formal assessment report is typically toowordy and off putting to accomplish this aim. Writing the report may be animportant and perhaps critical part of the assessment and analysis process, andrepresent an invaluable contribution to the person’s case file for future reference.In contrast, a visual portrayal may help current staff obtain a mutual understandingof why a person does what he does and, from this common attribution, a platformfrom which the team can work in a coordinated way to support the person. Wethank Peter for his very thoughtful contribution.

IntroductionThe importance of identifying the factors which may have given rise

to, or maintain, an individual’s challenging behavior has repeatedly beenrecognized as crucial if a successful intervention is to be devised (Carr &Durand, 1985; Didden, Duker, & Korzilius, 1997; Repp, Felce, & Barton,1988; Scotti, Evans, Meyer, & DiBenedetto, 1991). Indeed, intervention

without this sort of understandingmay well be harmful and thereforeunethical. Reaching an understand-ing of individuals who present chal-lenging behaviors, to a degree thatenables the construction of inter-vention plans, is not without it’sdifficulties. Not only is an under-standing of the immediate contin-gencies affecting an individual’sbehavior required, but in additionit is necessary to understand howthis has been shaped by their his-tory and concurrent personal andenvironmental factors. Much hasbeen written regarding the collec-tion of information required to carryout a functional analysis. How-ever, less attention has been paid tothe process of synthesizing thisvast array of information, beyondfairly unspecified instructions tosummarize the information(O’Neill, 1990; Willis & LaVigna,

18


1996 a; b). The complex multi-variate nature ofcausation was recognized by LaVigna & Willis (1995),who suggested that this complexity needs to bematched by multielement support plans, in order thatintervention with such individuals is maximally ef-fective.

The reality for many people involved in the designof support plans for indi-viduals who present chal-lenging behavior is, to agreater or lesser degree, areliance on others. Thesemediators are required notonly to supply informationto assist functional analy-sis, but are also required toimplement the interven-tions devised. The latterraises almost inevitableproblems with regard toconsistency of implemen-tation. Researchers using acognitive - behavioral paradigm have begun to dem-onstrate that staff responses to challenging behaviormay well be influenced by contingencies that arerelated to how they experience that behavior, inparticular, attributions regarding causation and theiremotional response (Dagnan, Trower & Smith, 1998;Hastings & Remington, 1994; Oliver, 1993). It isfeasible that inconsistent responses may well be de-termined by individual differences in con-ceptualization. For example, the response by carerswho believe the function of the individual’s behavioris to elicit attention would be very different fromcarers whose perception of function is that of socialavoidance. In addition, Toogood & Timlin (1996)demonstrated the influence carers’ perceptions ofseverity might have on the process of functionalanalysis. They found that the perception of the sever-ity of the challenging behavior affected the degree towhich informant based functional analysis method-ologies were able to identify functions. Clearly ashared understanding of the individual would greatlyimprove the likelihood of consistent program imple-mentation and consequently maximize the chances ofsuccess. Thus any aids to the process of understand-ing, especially those which assist synthesis of infor-

These (contingency diagramsare not considered to be areplacement of the more

traditional narrative forms ofpresenting the results of a

functional analysis, but ratheras an adjunct.

mation and the communication of formulations, shouldbe welcome.

Willis and LaVigna (1993) produced the BehaviorAssessment Guide, an extremely comprehensive as-sessment procedure involving gathering informationfrom a wide range of sources and summary, synthesisand analysis in the form of a written report. The results

of these assessments canoften be written reports oftelephone book length, us-ing complex terminologythat British care staff, atleast, find inaccessible oroff-putting. There is nodoubt as to the value ofthese written reports to theauthor or those with a simi-lar degree of sophistica-tion, but the extent to whichthey really meet the needto communicate complexformulations to direct care

staff could be questioned.The Challenging Needs Service in Hastings, East

Sussex, England have found contingency diagrams tobe an invaluable additional tool in their efforts topresent and communicate relatively complex formu-lations. These diagrams are not considered to be areplacement of the more traditional narrative forms ofpresenting the results of functional analysis, but ratheras an adjunct. Additionally, the discipline of produc-ing these diagrams has been found to aid the processof synthesis of information in order to arrive at theformulation. Contingency diagrams are now routinelyincluded in the initial reports and are commonly used,usually in the form of an overhead projector slide, inpresentation of the formulations to groups of carers.

The following example illustrates how quite acomplex array of information gathered from interviewcan be represented on a single sheet of paper. Informa-tion is presented regarding Tom in a manner thatwould resemble the initial stages of hypothesis gen-eration based on information gleaned from staff throughinterview.

Tom is a 22-year-old man with severe learn-ing disabilities who has recently moved into anew staffed house with three other adults with


19

learning disabilities. Previously he had livedsince the age of 4 years in an institution forpeople with learning disabilities. He has a longhistory of self-injurious behavior; he frequentlyhits his head on the floor, on walls, on furnitureand other hard surfaces.

Tom has very limited speech, just a few wordswhich he may use for avariety of needs. For ex-ample, “dinner” maymean food in general, and“toilet” may mean thathe wants to be on his own.All the residents’ roomsare locked, at times, toprevent “trespass.” Tomcan’t use his key and staffalways carry keys to allrooms. He also has asmall repertoire of Makaton (British signingsystem), mainly “please” and “drink”. In gen-eral, it is not always clear from Tom’s commu-nications what it is he wants and this can lead toself-injury if his requests are misunderstood.

Tom needs help with his self-help and per-sonal hygiene skills, and assistance throughmost of his activities. He is, however, the mostable resident in the house and sometimes missesout on staff interactions because they are keptvery busy with those who need a lot of help.

Tom is a very mobile young man who canmove at great speed when he wants to. Once ortwice he has slipped out through the back door,and through the garden, and has been foundwandering up the road towards the town center.He has very little road sense, so he needs to havestaff with him at all times when out in thecommunity. Similarly, he has on occasions gotinto the kitchen, which is usually locked, andraided the larder; he has a voracious appetite!

Tom enjoys being out and about — walks,trips into the community and letting off steam inthe park. Indoors he particularly enjoys activi-ties involving food - cooking and eating meals,and even clearing away and washing up! He’snot so keen on sedentary activities - watching TVand playing table games etc. However, he loves

his personal stereo, though can’t operate thecontrols effectively and has broken two already.He now only has access to his new one when amember of staff is available to help him. Whenhe’s wearing his personal stereo he will happilylisten for long periods humming to the music andmay even sit down for quite a while. He also had

a full size cassetteplayer in his room thathe liked to listen to, butthis was broken by an-other resident andhasn’t been replacedyet.

Tom’s self-injurycan be quite serious attimes. Staff have keptrecords of this and haveformed some ideas

about what “sets it off.” Apart from occurringwhen he is frustrated by misunderstood requests,there are also other times when it seems likely tohappen. These include situations where Tom isdenied food. On one occasion recently he madeit clear that he wanted another sausage with hismeal but, unfortunately, there was only enoughfor two each and Tom had already had his; thisled to a major bout of self-injury. He also getsvery upset when he cannot have his personalstereo, or when he breaks it while using it. Theother two factors that are likely to affect his self-injury appear somewhat contradictory. That is,Tom sometimes wants to be on his own, but can’talways find the peace and quiet he’s after, eitherbecause his room is locked, or because the toiletis engaged. All other areas of the house arecommunal. This can lead to serious self-injury.Conversely, there are other times when Tom isreceiving very little staff attention and he mayget distressed because nothing’s going on. Stafffeel that self-injury at these times may be a formof self-stimulation because he’s bored.Figure 1 (page 20) would represent a preliminary

hypothesis, in particular illustrating the interactiveand dynamic nature of the variables.

The advantages of these diagrams in comparison toa lengthy written formulation are:

(This) example illustrates howquite a complex array of

information gathered frominterview can be represented on

a single sheet of paper.

20


• complex concurrent phenomena can be presentedsimultaneously rather than one…. word…. at…. a….time (Mattaini, 1995).

• the expected impact of each element of interventioncan be illustrated. For example, enhancing Tom’scommunication skills and training staff to under-stand Tom will result in fewer requests being mis-understood, with a consequent reduction in selfinjury.

• people with learning disabilities and their carersoften feel more comfortable with information that

is presented visually rather than in writing. As aresult a shared understanding and a working part-nership are more likely to be achieved (Murphy &Clare, in press).

Construction of the DiagramsThere are no set rules for the construction of contin-

gency diagrams and examples of differing methodolo-gies can be found, e.g. Clare & Murphy (in press);Mallot, Whaley & Mallot (1993) & Mattaini (1995).

Learning Disability Impoverished environment• Unstimulating• ‘do for’• limited expectations• limited equipment• small food portions

Limited functionalskills

‘can’t do it’

Poorcommunication

skills

Ask staff forhelp/access

Requestmisunderstood/

denied

SIB

Staff backdown (grantrequest)/increase

effort to understand

Object/activity madeavailable SIB stops

Increased need for attention

Lowstaff:client

ratios

Unskilledinexperienced

staff

Less reliance on appropriate

communication

Figure 1 - Tom’s Contingency Diagram


21

However, our experience has shown that the follow-ing steps are the most straight forward.

1. The starting point should be the immediate oper-ant contingencies. In the case of Tom, it ap-peared that his self-injurious behavior was main-tained by access to tangibles. That is, self-injurywould be preceded by a request being denied(either deliberately or through misunderstand-ing) and followed by the object of the requestbeing made available.

2. After the three term contingencies have beenrepresented, the environmental (both currentand historical) and personal variables can beadded. These variables often function as estab-lishing operations (Michael, 1982) or settingevents, i.e., they serve to increase the momen-tary potency of the maintaining reinforcers. Inthe case of Tom, a complex array of historical,environmental and personal variables would beimplicated. In particular, the unstimulating na-ture of the environment would enhance the rein-forcing properties of, for example, his personalstereo. These types of factors can be seen asconcurrently influencing the contingencies sur-rounding his self-injury.

3. In addition to the immediate consequences moredelayed or less direct consequences of the be-haviors can be represented. In the case of Tom,the relationship between his challenging behav-iors and gaining access to tangible reinforcerswill potentially result in less reliance on appro-priate forms of communication, resulting in theincreased likelihood of future misunderstand-ings. These often present as vicious circles andmay well be identified as a priority for interven-tion, given that if left unaddressed, they maywell become more ingrained.

SummaryAs an adjunct to more traditional narrative presen-

tation of the results of functional analysis, contin-gency diagrams have been found to be a useful tool inthe assessment of individuals with learning disabili-ties who present challenging behavior. They haveproven to be useful both as an aid to synthesis ofpotentially enormous complex and inter-related infor-

mation and in the communication of formulations todirect care staff.

References

Carr, E. G., & Durand, V. M. (1985). Reducing behavior problemsthrough functional communication training. Journal of AppliedBehavioral Analysis, 18, 111-126.

Clare, I. C. M., & Murphy, G. H. (in press). Working with offenders oralleged offenders with intellectual disabilities. In Clinical Psychologyand People with Intellectual Disabilities (ed. E. Emerson, A. Caine,J. Bromley, C. Hatton). John Wiley, Chichester.

Dagnan, D., Trower, P., & Smith, R. (1998). Care staff responses topeople with learning disabilities and challenging behavior: Acognitive -emotional analysis. British Journal of Clinical Psychology,37, 1-10.

Didden, R., Duker, P., & Korzilius, H. (1997). Meta-analytic study ontreatment effectiveness for problem behaviors with individuals whohave mental retardation. American Journal of Mental Retardation,101 (No. 4), 387-399.

Hastings, R. P., & Remington, B. (1994). Staff behavior and itsimplications for people with learning disabilities and challengingbehaviors. British Journal of Clinical Psychology, 33, 423-438.

LaVigna, G. W., & Willis, T. J. (1995). Challenging behavior: A modelfor breaking the barriers to social and community integration.Positive Practices, 1(1), 1, 8-15.

Mallot, M. A., Whaley, D. L., & Mallot, M. E. (1993). Elementaryprinciples of behavior, (2 ed.) Englewood Cliffs, NJ: Prentice Hall.

Mattaini (1995). Contingency diagrams as teaching tools. The BehaviorAnalyst, 1, 93-98.

Michael, J. (1982). Distinguishing between discriminitive andmotivational functions of stimuli. Journal of the ExperimentalAnalysis of Behavior, 37(1), 149-155.

Oliver (1993). Self-injurious behavior: From response to strategy. InC. Kiernan (Ed.), Research to practice? Implications of research onthe challenging behavior of people with learning disability. Cleveland,Avon: BILD Publications.

O’Neill, R. E. (1990). Functional analysis of problem behavior: apractical assessment guide, Sycamore Publishing, Sycamore IL.

Repp, A. C., Felce, D., & Barton, L. E. (1988). Basing the treatment ofstereotypic and self-injurious behaviors on hypotheses of theircauses. Journal of Applied Behavioral Analysis, 21(3), 281-289.

Scotti, J. R., Evans, I. M., Meyer, L. H., & DiBenedetto, A. (1991).Individual repertoires as behavioral systems: Implications for programdesign and evaluation. American Journal of Mental Retardation,96(3), 233-256.

Toogood, S., & Timlin, K. (1996). The functional assessment ofchallenging behavior. Applied Research in Intellectual Disabilities,9, 206 - 222.

Willis, T. J., & LaVigna, G. W. (1996a). Behavior Assessment: Anoverview. Positive Practices, 1(2), 1, 8-15.

Willis, T. J., & LaVigna, G. W. (1996b). Behavior Assessment: Anoverview. Part 2. Positive Practices, 1(3), 1, 11-19.

Willis, T. J., LaVigna, G. W., & Donnellan, A. M. (1993). Behaviorassessment guide. Los Angeles: Institute of Applied BehavioralAnalysis.

22


VOLUME INumber 1 • October 1995

Challenging Behavior: A Model for Breaking theBarriers to Social and Community Integration .............................. Page 1

Positive Programming: An OrganizationalResponse to Challenging Behavior ............................................... Page 3

A Person Centered Approach to SupportingPeople with Severe Reputations ................................................. Page 16

Definition of a Problem Behavior (Aggression) ........................... Page 18

Procedural Protocols - Interpersonal Style ................................. Page 21

Number 2 • January 1996Behavioral Assessment: An Overview Part 1 .............................. Page 1

The Behavior Intervention Support Team Program: AddressingChallenging Behavior of Peoplewith and Intellectual Disability inVictoria, Australia” .......................................................................... Page 3

Definition of a Problem Behavior(Unexplained Possession) ........................................................... Page 16

Procedural Protocols - Interactional Style ................................... Page 17

Number 3 • April 1996Behavioral Assessment: An Overview Part 2 .............................. Page 1

The Development of a Statewide BehaviorResource in the State of Montana ................................................. Page 3

Definition of a Problem Behavior(Inappropriate Interactions) ......................................................... Page 20

Procedural Protocols - Transition ................................................ Page 21

Number 4 • July 1996Behavioral Technology in Support of Values ................................ Page 1

Quality Monitoring at Church Parade ............................................ Page 3

Definition of a Problem Behavior (Defiance) .............................. Page 17

Procedural Protocols - Behavioral Escalation ............................ Page 18

Resource Focus: Competency Based Training .......................... Page 22

VOLUME IINumber 1 • October 1996

Motivational Analysis ..................................................................... Page 1

Psychometric Characteristics of EvaluationInstruments for Behavioral Assessment Reportsand Intervention Plans ................................................................... Page 3

Definition of a Problem Behavior(Anxiety Outbursts) ...................................................................... Page 15

Procedural Protocols - Learning toTolerate and Cope with Denial .................................................... Page 17

Profiles in Courage ...................................................................... Page 21

Number 2 • January 1997Severe and Challenging Behavior: Counter-

Volume Index October 1996 through April 1998

Intuitive Strategies for Crisis ManagementWithin a Nonaversive Framework ................................................. Page 1

Quality Assurance: What Made it Work For Us ............................ Page 3

Daily Life of a Person Who is Disabled ......................................... Page 7

Commentary on a Speech on the DailyLife of a Person Who is Disabled .................................................. Page 8

Definition of Problem Behavior(Verbal Defiance/Resistance) ...................................................... Page 18

Procedural Protocols -Task Interruption:Self Direction ................................................................................ Page 19

Number 3 • April 1997Respondent Strategies .................................................................. Page 1

Understanding and Helping a Boy with Problems: a FunctionalApproach to Behavior Problems .................................................... Page 3

Definition of Problem Behavior (InappropriateSexual Behavior) .......................................................................... Page 19

Procedural Protocols - Wearing a Bra ........................................ Page 21

Number 4 • July 1997Applying Cognitive-Behavioral Approachesto the Carers of People with Learning Disabilitieswho Display Challenging Behavior ................................................ Page 1

The Use of Edited Videos for the Treatmentof Selective Mutism ........................................................................ Page 3

Definition of a Problem Behavior ................................................. Page 19

Procedural Protocol ..................................................................... Page 21

VOLUME IIINumber 1 • October 1997

Suzanne Wishes to Retire: A Case Example ............................... Page 3

Definition of a Problem Behavior andProcedural Protocol ..................................................................... Page 19

Letters to the Editors ................................................................... Page 21

Number 2 • January 1998Mediator Analysis .......................................................................... Page 1

An Application of Crisis Services Withinthe Multielement Approach: A CommunityBehavioral Support and Crisis ResponseDemonstration Project ................................................................... Page 3

Number 3 • April 1998Anger Management and Assertiveness Skills:Use of a Curriculum in Supported LivingServices .......................................................................................... Page 1

Rug Rats, Videos and the Use of EcologicalStrategies in the Rapid Reduction of a Severe and ChallengingBehavior Problem .......................................................................... Page 3

The Use of Contingency Diagrams in theFunctional Analysis of Challenging Behavior ............................. Page 17

TO ORDER BACK ISSUES USE THE ORDER FORM ON PAGE 23


23

Eleventh Annual Two Week Summer Institute on

Assessment & Analysis ofSevere & Challenging Behavior

July 25 - August 7, 1999 • Los Angeles

For a complete description of the course,registration procedure and fees, contact:

Institute for Applied Behavior AnalysisPO Box 5743

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Toll Free (US & Canada): (800) 457-5575Internet: [email protected]

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��IABA’s 2nd International Conferenceto Advance Positive Practices in the

Field of Challenging Behavior

Contact John Marshall for more informationTel: +1 (864) 271-4161 • Fax: +1 (864) 271-4162

E-mail: [email protected] and participation limited to previousparticipants in IABA’s Two Week Institute and

Longitudinal Training.

Walt Disney World, FL • January 6-9, 1999

1998 International TASHConference

Seattle, Washington

December 3-5, 1998

Seattle Sheraton Hotel and Towers - WashingtonState Convention Center

(Pre-Conference Workshops & Opening Receptiononly on December 2nd)

For questions about the 1998 TASH Conference, or toobtain a registration packet e-mail Denise Marshall

([email protected])or call 410-828-8274 x 103.

http://www.tash.org

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ResourcesTraining Calendar

Alternatives to Punishment: Solving BehaviorProblems with Nonaversive StrategiesG.W. LaVigna & A.M. Donnellan

“(This book) provides a comprehensive treatmentof alternatives to punishment in dealing with behaviorproblems evidenced by human beings at various levelsof development and in various circumstances. Basedupon their own extensive observations and athoroughgoing analysis of relevant experimental studies,(the authors) have put together a document that is atonce a teaching instrument, a summary of research, andan argument for the use of positive reinforcement in thetreatment of inadequate or undesired behavior… alandmark volume which should forever lay the ghost thataversive methods (even the ubiquitous ‘time out’) needto be applied to the delinquent, the retarded, or thenormal ‘learner,’ whether in the home, the school, theclinic, or other situations.” — Fred S. Keller (From thePreface to Alternatives to Punishment) - paper, $19.50/ISBN 0-8290-1245-1

The Behavior Assessment GuideT.J. Willis, G.W. LaVigna & A.M. Donnellan

The Behavior Assessment Guide provides theuser with a comprehensive set of data gathering andrecords abstraction forms to facilitate the assessmentand functional analysis of a person’s challenging behaviorand the generation of nonaversive behavioral supportplans. Permission has been granted by the authors toreproduce the forms for professional use. -spiral, $21.00

Progress Without Punishment: EffectiveApproaches for Learners with Behavior ProblemsA.M. Donnellan, G.W. LaVigna, N. Negri-Schoultz, &L. Fassbender

As individuals with special educational anddevelopmental needs are increasingly being integratedinto the community, responding to their challengingbehavior in a dignified and appropriate manner becomes

essential. In this volume, the authors argue against theuse of punishment, and instead advocate the use ofalternative strategies. The positive programming modeldescribed in this volume is a gradual educational processfor behavior change, based on a functional analysis ofproblems, that involves systematic instruction in moreeffective ways of behaving. The work provides anoverview of nonaversive behavioral technology anddemonstrates how specific techniques change behaviorthrough positive means. The extensive examples andillustrative material make the book a particularly usefulresource for the field.-paper, $17.95/ISBN 8077-2911-6.

Social Skills Training for Psychiatric PatientsR.P. Liberman, W.J. DeRisi, & K.T. Mueser

This guide to the application of social skills trainingwith psychiatric patients systematically provides clinicianswith the ingredients necessary to start and run their ownsocial skills groups. Case examples, transcripts of socialskills training sessions and exercises aid the reader inapplying the training methods.-paper, $28.95/ISBN 0-08-034694-4

The Role of Positive Programming InBehavioral TreatmentG.W. LaVigna, T.J. Willis, & A.M. Donnellan

This chapter describes the role of positiveprogramming in supporting people with severe andchallenging behavior. After discussing the need forpositive programming within a framework based onoutcome needs, variations of this strategy are delineated.Then, assessment and analysis are described as criticalfor comprehensive, positive, and effective support. Acase study of severe aggression is presented to illustratethe process of assessment and analysis, the supportsthat follow from this process, and the long term results ofthis approach. - spiral, $5.00

The Periodic Service Review: A Total QualityAssurance System for Human Services &EducationG.W. LaVigna, T.J. Willis, J.F. Shaull, M. Abedi, &M. Sweitzer

Evolving from more than a decade of work at IABA,this book provides the tools needed to enhance andmaintain high quality service delivery. Translating theprinciples of organizational behavior management andtotal quality management into concrete policies andprocedures, the Periodic Service Review (PSR) acts asboth an instrument and a system. As an instrument, thePSR provides easy to follow score sheets to assess staffperformance and the quality of services provided. As asystem, it guides managers step-by-step through 4interrelated elements — performance standards,performance monitoring, performance feedback, andsystematic training — to offer an ongoing process forensuring staff consistency and a high level of quality forservices and programs. Practical examples show howthe PSR is applied to group home, supported living,classroom, and supported employment settings, and thehelpful appendices provide numerous tables and chartsthat can easily be tailored to a variety of programs. -$37.95/ISBN 1-55766-142-1

Add for Shipping to US Addresses:1st book (min.) $4.00 Each add’l book $0.75

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Foreign orders must be made in U.S. currency bybank draft, international money order or credit card.

(Prices are subject to change without notice.)

Multimedia Training Programs

Competency Based Training ProgramThis is a systematic, criterion-referenced, self-

instructional multimedia course for staff developmentthat is customized to your agency. It is being used byadult service agencies and schools in Australia, GreatBritain, Spain and the US. $1,500.00

For more information on the CBT, contact:Diane Sabiston


Savannah, GA 31410-0726 USATelephone: (912) 231-0707 • Fax: (912) 231-6684

Positive Approaches to Solving BehaviorChallenges

This is a 6 module video training program thatteaches viewers IABA’s person centered multielementmodel for developing nonaversive support plans forpeople with challenging behavior. Two text books,lecture notes and pre/post tests are included. $1,250.00

Staff Supervision and Management Strategies forQuality Assurance

This is a 4 module video training program basedon The Periodic Service Review: A Total QualityAssurance System for Human Services and Education.Viewers will learn concrete strategies to ensure that thehighest quality services are being provided by theiragency/school. Text book, lecture notes and participantexercises are included. $750.00

For more information, contact:

John Q. Marshall, Jr.Director of Professional Training ServicesInstitute for Applied Behavior Analysis

PO Box 5743Greenville, SC 29606-5743 USA

Telephone: (864) 271-4161 • Fax: (864) 271-4162

and Emergency Management. AssuringStaff Consistency Through the PeriodicService Review: A Quality Managementand Outcome Evaluation System is a 1 dayseminar that teaches participants a staffmanagement system that ensures theagency/school is providing quality services.

July, 1998 - US Seminars (Los Angeles)August, 1998 - US Seminars (Salinas, CA)September, 1998 - US Seminars (Greenville,

SC)October, 1998 - UK Seminars (London,

Edinburgh, Belfast, Manchester,Sheffield, Birmingham)

Supported EmploymentFebruary, 1999 - Australian Seminars

(Brisbane, Sydney)February, 1999 - New Zealand Seminars

(Christchurch, Wellington)

1998 TASH Conference“Creating Futures Together”

Seattle • December 2-5, 1997

Other venues will be arranged and announced at a later date. Fordetailed, current information on any seminar, contact:

Institute for Applied Behavior AnalysisPO Box 5743 • Greenville, SC 29606-5743 USA

Phone: +1 (864) 271-4161 • Fax: +1 (864) 271-4162Internet: [email protected] • http://www.iaba.com

Toll Free (USA and Canada): (800) 457-5575In the United Kingdom contact: The Tizard Centre • (01227) 827755

Assessment and Analysis of Severeand Challenging BehaviorGary W. LaVigna & Thomas J. Willis

This competency-based trainingpracticum provides participants with theclinical skills required to design andimplement person-centered multielementnonaversive support plans.Los Angeles • July, 1998London • October, 1998Los Angeles • July, 1999

IABA’s International Conference toAdvance Positive Practices in the Fieldof Challenging Behavior

Enrollment l imited to previousparticipants in IABA’s Two Week Instituteand Longitudinal Training.Walt Disney World, FL • January 6-9,1999

Positive Approaches to SolvingBehavior Challenges and The PeriodicService ReviewGary W. LaVigna & Thomas J. Willis

Positive Approaches… are 2, 3 & 4 dayseminars that present IABA’s multielementmodel for providing person centerednonaversive behavioral supports to peoplewith challenging behavior. These seminarscover Basic Principles of NonaversiveBehavior Support, Behavioral Assessment

Printed Resources Available from IABA

INSTITUTE FOR APPLIED BEHAVIOR ANALYSIS POSITIVE PRACTICES - IABA

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