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Positive Behavioral Support

Positive Behavioral Support

Including People with Difficult Behavior in the Community
Volume Editors: Lynn Kern Koegel Ph.D., CCC-SLP, Robert L. Koegel Ph.D., Glen Dunlap Ph.D.   Chapter Authors: Lise K. Fox Ph.D., Richard W. Albin Ph.D., Jacki L. Anderson Ph.D., William R. Ard Jr., Jon S. Bailey Ph.D., Wendy K. Berg, Stephen M. Camarata Ph.D., Edward G. Carr Ph.D., Carol Davis, Kathleen M. Feeley Ph.D., K. Brigid Flannery Ph.D., Robert H. Horner Ph.D., Susan S. Johnston Ph.D., Ann P. Kaiser, Gigi De Vault, K. Mark Derby Ph.D., William L.E. Dussault, Jay W. Harding, Norris G. Haring Ph.D., Peggy P. Hester Ph.D., Tiina M.D. Itkonen, Diane Hammon Kellegrew Ph.D., Craig H. Kennedy Ph.D., BCBA, Donald Kincaid Ed.D, Joseph M. Lucyshyn Ph.D., Joe Reichle Ph.D., Todd R. Risley Ph.D., Laura Schreibman Ph.D., Frank W. Kohler Ph.D., Darlene Magito-McLaughlin, Mary McEvoy Ph.D., Gail McGee Ph.D., Kimberly B. Mullen, Cheryl Nickels, Karen L. Pierce, Stephanie Peck Ph.D., Christine E. Reeve, Elisabeth Rogers Ph.D., Audrey Russo M.T.A., Wayne Sailor Ph.D., Aubyn C. Stahmer Ph.D.,, Phillip S. Strain Ph.D., Ann Turnbull Ed.D., H. Rutherford Turnbull III, Denise D. Shearer, Connie C. Taylor Ph.D., David P. Wacker Ph.D., Kathleen Wolff M.S., Bobbie J. Vaughn Ph.D., BCBA

ISBN: 978-1-55766-228-6
Pages: 528
Copyright: 1996
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This strategy-packed resource demonstrates how people with challenging behavior can be fully included at home, at school, and in the community. Based on solid research, it offers state-of-the-art intervention techniques and explores the planning and assistance needed to implement nonaversive inclusion strategies. Compelling case studies that illustrate successful integration make this person- and family-centered book essential for everyone involved with people with difficult behavior.

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Review: Mental Retardation
"Readers who are interested in new ideas and general trends . . . will find this book stimulating and informative."
Section I: Family Issues and Family Support

  1. Parent Education for Prevention and Reduction of Severe Problem Behaviors
    Lynn Kern Koegel, Robert L. Koegel, Diane Kellegrew, and Kimberly Mullen
  2. Early Intervention and Serious Problem Behaviors: A Comprehensive Approach
    Glen Dunlap and Lise Fox
  3. Developing Long-Term Reciprocal Interactions Between Parents and Their Young Children with Problematic Behavior
    David P. Wacker, Stephanie Peck, K. Mark Derby, Wendy Berg, and Jay Harding
  4. Contextual Fit for Behavioral Support Plans: A Model for "Goodness of Fit"
    Richard W. Albin, Joseph M. Lucyshyn, Robert H. Horner, and K. Brigid Flannery
  5. Group Action Planning as a Strategy for Providing Comprehensive Family Support
    Ann P. Turnbull and H. Rutherford Turnbull, III
Discussion: Norris G. Haring and Gigi De Vault

Section II: Education Issues
  1. A Gift from Alex—The Art of Belonging: Strategies for Academic and Social Inclusion
    Cheryl Nickels
  2. How Everyday Environments Support Children's Communication
    Ann P. Kaiser and Peggy P. Hester
  3. New Structures and Systems Change for Comprehensive Positive Behavioral Support
    Wayne Sailor
  4. Reducing Corporal Punishment with Elementary School Students Using Behavioral Diagnostic Procedures
    Connie C. Taylor and Jon S. Bailey
  5. Coordinating Preservice and In-Service Training of Early Interventionists to Serve Preschoolers Who Engage in Challenging Behavior
    Joe Reichle, Mary McEvoy. Carol Davis, Elisabeth Rogers, Kathleen Feeley, Susan Johnston, and Kathleen Wolff
  6. Avoiding Due Process Hearings: Developing an Open Relationship Between Parents and School Districts
    William L.E. Dussault
Discussion: Lynn Kern Koegel and Robert L. Koegel

Section III: Social Inclusion
  1. Social Relationships, Influential Variables, and Change Across the Life Span
    Craig H. Kennedy and Tiina Itkonen
  2. Examining Levels of Social Inclusion within an Integrated Preschool for Children with Autism
    Frank W. Kohler, Phillip S. Strain, and Denise D. Shearer
  3. On the Importance of Integrating Naturalistic Language, Social Intervention, and Speech-Intelligibility Training
    Stephen M. Camarata
  4. Alternative Applications of Pivotal Response Training: Teaching Symbolic Play and Social Interaction Skills
    Laura Schreibman, Aubyn C. Stahmer, and Karen L. Pierce
Discussion: Glen Dunlap

Section IV: Community Inclusion
  1. The Relationship Between Setting Events and Problem Behavior: Expanding Our Understanding of Behavioral Support
    Robert H. Horner, Bobbie J. Vaughn, H. Michael Day, and William R. Ard, Jr.
  2. Contextual influences on Problem Behavior in People with Developmental Disabilities
    Edward G. Carr, Christine E. Reeve, and Darlene Magito-McLaughlin
  3. Get a Life! Positive Behavioral Intervention for Challenging Behavior Through Life Arrangement and Life Coaching
    Todd Risley
  4. Person-Centered Planning
    Don Kincaid
  5. A Team Training Model for Building the Capacity to Provide Positive Behavioral Supports in Inclusive Settings Jacki L. Anderson, Audrey Russo, Glen Dunlap, and Richard W. Albin
Discussion: Gail McGee

Excerpted from Positive Behavioral Support: Including People with Difficult Behavior in the Community, edited by Lynn Kern Koegel, Ph.D., Robert L. Koegel, Ph.D., & Glen Dunlap, Ph.D.

Copyright © 1996 by Paul H. Brookes Publishing Co. All rights reserved.


Independent Functioning

Although the benefits of procedures designs to improves motivation and teach functional communication have had quite a significant effect both on improving language skills and decreasing inappropriate and disrupting behaviors (e.g., Koegel, Koegel, & Suratt, 1992), the need to address the child's independence remains an area warranting attention. Many of the existing parent intervention programs designed to teach communication and other skills to children frequently become overly dependent on their parents, often exhibiting newly learned behaviors only in their presence. To deal with this problem, researchers have concentrated efforts on developing programs to increase independent responding and communication through the use of self-management and child-initiated language learning strategies.

Child Self-Management

Self-management as a pivotal behavior taught in the context of parents education was developed to reduce the need for constant parental vigilance and to increase the child's independence. Self-management has been shown to be effective with a variety of populations including children without disabilities (Broden, Hall & Mitts, 1971; Drabman, Spitalnic, & O'Leary, 1973), people with mild to moderate mental retardation (Gardner, Cole, Berry, & Nowinski, 1983; Horner & Brigham, 1979), and children with learning disabilities (Dunlap, Dunlap, Koegel, & Koegel, 1991). For children with autism, preliminary research is suggesting that self-management is an effective tool to promote the use of newly learned behaviors in the absence of a trained interventionist (Koegel & Koegel, 19990; Koegel, Koegel, Hurley, & Frea, 1992).

The general steps in a self-management program include the following:

  1. Operationally defining the target behavior(s)
  2. Identifying functional reinforces for the child to earn
  3. Designing a self-monitoring method or device
  4. Teaching the child to use the self-monitoring device
  5. Fading the use of the self-monitoring device
  6. Validating whether the child is using the self-monitoring device in natural environments

We have been teaching self-management in the context of parent education so that parents can apply the procedures to any behaviors they want to teach their children to perform independently. Following are descriptions of a few self-management programs tat have been implemented in the homes of children with autism with their parents' assistance. Although similar conceptually, self-management procedures from those used for children who are more skilled In this area. Research suggests that pictorial self-management may be most effective for nonverbal children (Pierce & Schreiban, 1994).

We are currently implementing programs in which parents choose target behaviors they desire their child to use, and intervention is implemented in the context of self-management. The parents attend weekly sessions in which teaching self-management is practiced, and then throughout the week they implement the procedures in the community setting they have chosen. For example, one family whose 9-year-old child displayed limited verbal skills chose lunch packing as a target goal. In this particular family, the mother worked in the evenings and felt it would be helpful if her son packed his own lunch. To accomplish this, we drew several pictures including a lunch box, napkin, sandwich, drink, fruit, and vegetable. Lunch items were pre-cut and placed in a plastic refrigerator container. We first showed the child one picture, the lunch box, and taught him to take it out and open it. Next a second picture was added, such as the sandwich, and the child was taught to put all the items in his lunch box after he was given the set of cards. To be sure that he was actually self-monitoring and not simply learning a rote routine, the order of the cards was frequently changed. This ensured that the child was actually responding independently by attending to each particular card. Similar programs using pictorial self-management have been successfully implemented with nonverbal children or children with limited verbal skills to complete dressing in the morning, setting the table, self-care skills in the evening and so forth.

For children with verbal skills, some behaviors lend themselves more readily to event-monitoring procedures (such as those described above), and others are more easily monitored through interval recording, where the child monitors intervals of time in which the behavior is exhibited. For example, Koegel, Koegel, Hurley, and Frea (1992) increased verbal responsivity following an adult's question using writs (golf) counters as a self-monitoring device for the child to monitor verbal response (events). Children were selected to participate in the study based upon their frequent failure to attempt to answer questions from others. The children were taught to answer the questions, then to press the wrist counter to earn a point following each successful interaction. The number of verbal response required by the child to receive a self-chosen reward was gradually increased (beginning with one during the first session and ending with several hundred in later session). It appeared that when the children were consistently involved in verbal interactions, the fluency of overall interaction seemed to make the interchange less difficult for them. The results indicated that, in addition to significantly improving the children's responsivity, the children all demonstrated decreases in untreated disruptive behaviors such as aggression, self-stimulation, and self-injury (apparently used for avoidance or escape purposes from the previously discontinues and confusing verbal interchanges.)

Another study (Koegel & Koegel, 1990) demonstrated the use of an interval system to self-manage self-stimulatory. In this study, the children wore a watch (purchased at a sports store) with a countdown alarm function. Children were taught to record intervals with the absence of self-stimulatory behavior when the alarm chimed. Initial intervals were very short to ensure success and then were gradually and systematically increased. Ultimately, the system was implemented throughout most of the child's day (e.g., school, other community settings), and the data indicated that this procedure was effective in reducing or eliminating self-stimulatory behavior without the continual presence of an intervention provider.

It should be noted that the major goal of teaching self-management in the context of parent education is to provide parents with the general procedures to design a program relevant to any behavior that may be conducive to change using such a technique, Following acquisition of the procedure involved, parents can implement programs to teach their children independence through self-managing many types of behavior in a variety of environments, such as a school, home, the park, and so on.

Self-Initiated Queries

A second area of focus related to child independence concerns child-initiated strategies to evoke language learning from the environment. Acquisition of lexical items and language learning from the environment. Acquisition of lexical items and language learning in typical children is often a result of their own initiations, which become increasingly sophisticated over the years. Many of these self-initiations are in the form of direct queries, such as asking questions. In fact, a common utterance during a child's acquisition of his or her first vocabulary words is "that?" (pronounced "dat?"), which is often used while pointing to items (Miller, 1981). this verbalization and nonverbal cue can be a specific prompt for a parent to label the item for the child (Halliday, 1975). Questions become increasingly more sophisticated and increase in number, so that by 4 years of age the typically developing child is using a variety of questions including forms that begin with "what", "where," "whose," "who," and "why."

In contrast to typical language developers, children with autism rarely, if ever, ask questions. Differences during language activities were analyzed by Wetherby and Prutting (1984), who discovered that in addition to emitting fewer utterances, children with autism use communication almost exclusively for protesting (e.g., "Stop it") and requesting (e.g., "Want cookie"). Unlike their peers who frequently requested information (e.g., "What's that?") and often labeled items (e.g., pointing to a doll's foot and saying "foot"), The children with autism never requested information, nor did they label items. Thus, these children are at an extreme disadvantage in terms of their ability to verbally gain access to information. To address this problem, we have begun teaching a series of child initiated utterances and have also assessed the effects of these utterances on language acquisition.

The first question we chose for the child to learn, and the earliest developmental form learned by typical children, was "what's that?" To accomplish this, the child's parents prompted him or her to ask the questions. In order to increase the child's motivation to ask the question, initial questions were prompted by hiding highly desired objects in bags, and when the child queried, "What's that?", with regard to the contents of the bag, the parents labeled and then gave the child the highly desire item. Once the child was asking the target question and repeating the label of the item as a high frequency, other less familiar and less desired items were gradually added, and then the bag was removed. The end result was that the children continues to spontaneously ask questions about a variety of unfamiliar items in their various environments. Acquisition of vocabulary was assessed, and the results showed that the children demonstrated rapid gains in vocabulary following implementation of the self-initiated strategy. Furthermore, untreated disruptive behavior spontaneously decreased during sessions, suggestion that the increased language ability was replacing disruptive behavior as a form of communication.

A second question we target was "Where?" and we assessed the children's acquisition of prepositions. To increase the children's motivation to ask the question. their mothers hid desired items in various locations. For example, one child liked gummy bears so his mother hid them in various locations of a tabletop dollhouse. the children were prompted to ask, "Where is it?", then told the location(e.g., the prepositions in, on, under, behind). Prior to receiving the item, the children were required to repeat the preposition, As with the first study, all of the children were successful in learning a variety of prepositions and demonstrated generalized spontaneous use of the target question and prepositions.

The next child-initiated strategy we addressed was teaching the child to ask, "Whose is it?" to employ the possessive morpheme (e.g., "Daddy's") and to learn the possessive pronouns yours and mine. To teach yours and mine, items that were highly desired by the child were selected. The child was then prompted to ask, "Whose is it?" Before the desired item was given to the child, the parent said, "yours," and the child was taught to respond with "mine." Initially, it was necessary to ensure that all of the child's items ("mine") were highly desirable to the child, while all of the parents' items ("yours") were items belonging to the parents but of low interest to the child. The child also was taught to respond with "yours" when the parent said "mine." The possessive morpheme was taught analogously, using items that were highly desired; however, these items were interspersed with item that the child associated with a specific family member. For example, the mothers brought in items such as toys belonging to the child's siblings, or a slipper belonging to the father. Following the question "whose is it?" the mother was responded with "It's Teddy's," or "It's Daddy's." The child was required to repeat the possessive and then was given the item.

While study relating to the child independence is still in its infancy, an accumulating database is suggesting that strategies requiring children to serve as their own intervention providers shift some of the responsibility off of the parents. This may have the additional benefit of reducing some of the stress associated with the increased demands related to raising a child with a disability. In short, the use of child-initiated learning strategies is likely to both accelerate learning and provide for reduced stress levels in the family. As such, this area is expected to gain increased research attention in the future.

Excerpted from Positive Behavioral Support: Including People with Difficult Behavior in the Community, edited by Lynn Kern Koegel, Ph.D., Robert L. Koegel, Ph.D., & Glen Dunlap, Ph.D.

Copyright © 1996 by Paul H. Brookes Publishing Co. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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