Evidence-Based
Practices
to
v
Reduce Challenging Behavior
Lise Fox, Ph.D.
University of South Florida
Session Discussion
Critical importance for developing
systems to support teacher
implementation of evidence-based
practices
Adoption of a promotion, prevention,
intervention model
Identifying evidence-based practices for
early educators
National Centers - Resources
Center on the Social and Emotional Foundations for Early Learning
(CSEFEL)
www.vanderbilt.edu/csefel
Technical Assistance Center on Social Emotional Intervention (TACSEI)
www.challengingbehavior.org
Key Messages
High quality caregiving + high quality
environments ≠ No challenging behavior
Addressing challenging behavior =
Promoting the development of social
competence
We have evidence-based practices; but
we need practitioners and systems to
implement those practices with fidelity
5
An estimated 9 to 13% of American children
and adolescents between ages nine to 17
have serious diagnosable emotional or
behavioral health disorders resulting in
substantial to extreme impairment.
(Friedman, 2002)
6
o More than half of students with
SED drop out of grades 9-12, the
highest rate for all disability
categories.
(U.S. Department of Education,
2002; 2006)
o At 2 years post high school,
58% of youth have been arrested
at least once and 42% are on
probation or parole. (NLTS2,
2005).
o Students with ED reported use
of alcohol (54%), illegal drug use
(36%), marijuana use (33%), and
smoking (53%) at rates higher
than all other disability categories
(NLTS2, 2008)
7
Over 15% of all students with disabilities (6-21) are
taking psychotropic medications (USDOE, 2005)
About 1/3 of all adolescent students with disabilities
have been suspended or expelled (USDOE, 2005)
8
9
Campbell (1995) estimated that approximately 10-15%
of all typically developing preschool children have
chronic mild to moderate levels of
behavior problems.
Children who are poor are much more likely to develop
behavior problems with prevalence rates that approach
30% (Qi & Kaiser, 2003).
10
Children who are identified as hard to
manage at ages 3 and 4 have a high
probability (50:50) of continuing to have
difficulties into adolescence (Campbell &
Ewing, 1990; Campbell, 1997; Egeland et al.,
1990).
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Early Predictors
•Temperamental
Difficulties
•Early Aggression
•Language
Difficulties
•Noncompliance
12
Family Factors
•Maternal Depression
•Harsh Parenting
•Stressful Family Life
Events
•Low Social Support
•Family Instability
13
Depression Hurts
Children of mothers who
•• D
were depressed in their
infancy are more likely to
be delayed
• Children of depressed
mothers are at increased
risk for behavior
problems, depression,
and mood disorders in
adolescence
14
15
The correlation between
preschool-age aggression
and aggression at age 10
is higher than that for IQ.
(Kazdin, 1995)
16
Early appearing
aggressive behaviors are
the best predictor of
juvenile gang
membership
and violence.
(Reid, 1993)
17
When aggressive and
antisocial behavior has
persisted to age 9, further
intervention has a poor
chance of success.
(Dodge, 1993)
18
Young Children with
Challenging Behavior:
•Are rejected by peers
•Receive less positive
feedback
•Do worse in school
•Are less likely to be
successful in
kindergarten
19
Preschool children are three times
more likely to be “expelled” than
children in grades K-12
(Gilliam, 2005)
20
Faculty in higher education early childhood programs
report that their graduates are least likely to be
prepared to work with children with persistently
challenging behavior
(Hemmeter, Santos, & Ostrosky, 2004)
21
Of the young children who need mental
health services, it has been estimated
that fewer than 10% receive services
for these difficulties.
(Kataoka, Zhang, & Wells, 2002)
22
There are evidence-based practices
that are effective in changing this
developmental trajectory…the
problem is not what to do, but rests
in ensuring access to intervention
and support (Kazdin & Whitley, 2006)
23
v
The Pyramid Model
Pyramid Model
Tertiary
Intervention
Secondary
Prevention
Universal
Promotion
Nurturing and Responsive
Relationships
Foundation of the pyramid
Essential to healthy social development
Includes relationships with children, families
and team members
Relationships
High Quality Environments
Inclusive early care and
education environments
Comprehensive system of
curriculum, assessment,
and program evaluation
Environmental design,
instructional materials,
scheduling, child guidance,
and teacher interactions
that meet high quality
practices as described by
NAEYC and DEC
Reviewing Rules
Transitions
Circle Time – Universal Design
Adult Support
From: www.headstartinclusion.org
Circle Time – Universal Design
Peer Support
From: www.headstartinclusion.org
Circle Time – Universal Design
Child Preference
Special Equipment
From: www.headstartinclusion.org
Circle Time – Universal Design
Environmental Support
From: www.headstartinclusion.org
Circle Time
Special Equipment
Circle Time
Child Preference
From: www.headstartinclusion.org
Circle Time
Invisible Support
From: www.headstartinclusion.org
Circle Time
Simplify the Activity
From: www.headstartinclusion.org
Targeted Social Emotional
Supports
Self-regulation, expressing
and understanding
emotions, problem solving,
developing social
relationships
Explicit instruction
Increased opportunities for
instruction, practice,
feedback
Family partnerships
Progress monitoring and
data-based decision-making
Friendship Skills
• Gives suggestions (play
organizers)
• Shares toys and other
materials
• Takes turns (reciprocity)
• Is helpful
• Gives compliments
• Understands how and
when to give an apology
• Begins to empathize
43
Book Nooks
www.vanderbilt.edu/csefel
On Monday
When
it Rained
Glad Monster
Sad Monster
Hands Are Not
for Hitting
Feeling Wheel & Feeling Dice
Turtle Technique
Recognize
that you
“Think”
Stop.
feel angry.
Go into shell.
Take 3
deep
breaths
and think
calm,
coping
thoughts.
Come out of
shell
when
calm and
think of a
solution.
Problem Solving Steps
Step 2
Would it be safe?
Would it be fair?
How would everyone feel?
47
The Solution Kit
48
Secondary – Skill Instruction
Identify target skill
Identify learning opportunities and seek to
maximize the number of learning trials
Select procedure for teaching
e.g., least to most, most to least, incidental
teaching procedure, peer support, modeling,
visual prompts
Track child progress
Individualized Intensive
Interventions
Comprehensive
interventions
Assessment-based
Skill-building
Partnerships with
families
Progress monitoring
and data-based decisionmaking
Positive Behavior Support
Convene a team
Conduct functional
assessment
Identify hypotheses
Develop behavior
support plan for all
relevant environments
About Tim
4 years old
Only child
First preschool experience
Strengths – very smart, loves books, engages well
with adults
Challenging Behaviors - Aggression, Verbal
threats, Destroys other children’s products,
Damages toys intentionally
Significant risk of Preschool Expulsion
Before PBS
Develop Plan
Team of individuals who know him best – teacher,
parents, paraprofessional, assistant director
Behavior consultant guided the process
Focused on understanding the purpose of Tim’s
challenging behavior - importance of gathering
information
Developed a comprehensive plan that includes:
Strategies for preventing his challenging behavior
New skills
Adult responses
Classroom team and family implement and monitor
plan outcomes
Hypotheses
Tim engaged in challenging behavior
to:
initiate social interactions
enter into play
get access to particular toys
get teacher or peer attention
Behavior Support Plan
Prevention Strategies
Social story to describe behaviors that were
expected during center play and outdoor
activities
Review of social story prior to center time
Priming to remember skills to use
Visual prompt to remember skills to use
I Can Be a SUPER FRIEND!
Created for Tim by Lisa Grant & Rochelle Lentini
2002
I like talking and playing
with my friends
at school.
Sometimes, I want to play
with what my friends are
playing with.
When I play, I sometimes feel like taking toys,
using mean words, or hitting and kicking.
My Friends get sad or mad
when I hit, kick, use mean
words, or take toys.
If I want to join in play, I need to join nicely
or ask to play with my friends’ toys.
Can I play with you?
I can say, “Can I play with that toy?”
or “Can I play with you?”.
I can join my friends and play nicely.
I can go with the flow.
I can take turns.
I can stop, think, and do.
I CAN BE A SUPER FRIEND
I can join my friends and play nicely.
________
I can take turns nicely.
________
I can go with the flow.
________
I can stop, think, and do.
________
DATE: ___________
Tim’s Plan (cont.)
Instructional Strategies
Social skills instruction of each new skill (role play
and story review)
Self-management system for new skills
Tim’s Plan (cont.)
New Responses
Attention to child who was assaulted
Prevent access to toy or activity
Review with Tim after incident has been
resolved
Tim – with PBS
“If a child doesn’t know how to read, we teach.”
“If a child doesn’t know how to swim, we teach.”
“If a child doesn’t know how to multiply, we teach.”
“If a child doesn’t know how to drive, we teach.”
“If a child doesn’t know how to behave, we…
… teach?… punish?”
67
Pyramid Model
Tertiary
Intervention
Secondary
Prevention
Universal
Promotion
Evidence-Based
Practices that
Promote the Social
Emotional
Development of All
Children
Assess your teaching
How skilled are you at….
Developing strong teaming relationships?
Developing parent partnerships?
Creating classroom environments that support the
active engagement of all children?
Teaching social emotional skills intentionally to all
children?
Teaching social emotional skills with sufficient
intensity to individual children who are at-risk of
challenging behavior?
Assess your Program
Does your program…
Have a system for screening children for
social emotional delays?
Ensure that children at-risk of challenging
behavior receive intentional instruction and
support that leads to outcomes?
Use data to make decisions about how to
support children effectively?
Assess your program
Does your program…
Have a system for ensuring that children
with persistent challenging behaviors
receive intensive, individualized support?
Offer teachers individualized
professional development (training and
coaching) to provide evidence-based
approaches?
National Centers - Resources
Center on the Social and Emotional Foundations for Early Learning
(CSEFEL)
www.vanderbilt.edu/csefel
Technical Assistance Center on Social Emotional Intervention (TACSEI)
www.challengingbehavior.org