Positive Behavior
Support in Community
Settings
February 3, 2004
Rachel Freeman
University of Kansas
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Positive Behavior Support
 Positive behavior support is the integration of
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Valued outcomes
Behavioral and biomedical science
Validated procedures
Systems change
In order to enhance quality of life and prevent
problem behavior
2
Characteristics of PBS
 PBS plans can be short or more
complicated
 Many different intervention choices can
result in same positive outcomes
 Must fit the values, vision, and resources
of those supporting the individual
 PBS plans requires team collaboration
 Purpose is to increase quality of life and
build a team vision
3
Why individuals Engage in
Problem Behavior
 If problem behavior is increasing look for events
that reinforce it
 Problem behavior increases when it is
reinforced
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To obtain attention, access to people, events, or
activities
To escape people, events or activities
 Problem behavior influenced by physiological
variables can occur to escape or obtain internal
stimulation
4
Common Functions Maintaining
Problem Behavior
 To escape from tasks, people, situations, or
internal sensations
 To obtain attention from staff, peers, or other
individuals
 To obtain access to preferred items or events
 To either escape or obtain internal sensations
due to physiological events
5
First Steps in PBS Process
 Medical check-up to ensure there isn’t a
health problem or medical issue
 Person-centered Planning
 Establish the team
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Person-centered Planning
 Process for identifying ideal lifestyle
 Creates a vision for the team
 Focus on the positive
 Gathers important information for the
PBS plan
 Decreases the need for more intensive
interventions
 Priority and control is given to the
individual
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Functional Assessment
 Identify why the person engages in problem
behavior
 Assess how to replace problem behavior with
desirable behavior
 Identify how to redesign the environment to
prevent problem behavior
 Link all interventions directly to information
gathered in the functional assessment
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Routines, Settings and People
Associated with the Occurrence and
Nonoccurrence of Problem Behavior
Problem Behavior
is Most Likely…
 Before work
 Transitions
 Sitting next to his
friend John on the
way to work
Problem Behavior is
Less Likely…
 Lunch
 Small groups
 Receiving high levels
of attention
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Developing a Hypothesis Statement
A Good Hypothesis Statement Includes the
Following Components:
1. Setting Event
2. Antecedent
3. Problem Behavior
4. Consequences
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Setting Events
 Environmental (noise levels, sitting next
to a peer, late to work)
 Social (fight during lunch, family crisis)
 Physiological (sickness, allergies, sleep
deprivation)
11
Antecedent Events (Triggers)
 Immediately precedes a problem
behavior
 Can be related to time of day, people,
specific settings, the physical
surrounding, or particular activities
 Common examples include verbal
demands, specific assignments, certain
peers or individuals
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Consequences
 An event that is presented contingent
upon the occurrence of problem
behavior
 Common consequences include staff
attention, the removal of a difficult task,
or the presentation of something the
person wants
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Hypothesis Statement
Setting Event
Antecedent
(Trigger)
Problem
Behavior
Consequence
Change in
work schedule
No attention
from staff or
peers
Pulls hair
Immediate
when
attention
someone is
nearby
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Activity
 Complete the hypothesis statement
activity in small groups or individually
 Write down the setting events,
antecedents, behaviors, and
consequences described in each
vignette
 Answer sheet
15
Types of Functional
Assessment Strategies
 Indirect assessment methods
 Direct observation
 Functional analysis
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Indirect Assessment
 Interviewing the person, her parents,
staff, and other individuals who know the
person well
 Record reviews
 Quality of life measures
 Checklists and rating scales
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Identify Routines
 The behavior occurs “all the time” is not
enough information
 Select the most problematic situations
and settings
 Collect functional assessment
information about specific routines
 Observe these routines
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Defining a Problem Behavior
 Avoid using a classification label (for example,
ADHD, autism, etc)
 Describe exactly what the behavior looks like
 Avoid using vague descriptions (temper tantrums
mean different things to different people)
 Make sure the behavior is described in such a
way that there is a clear beginning and ending
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Collecting Direct Observation Data
 To help you develop an initial hypothesis
 To confirm that your hypothesis is correct
 To create a baseline that can be used
later to evaluate the PBS plan
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Collect a Baseline of
Problem Behavior
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Direct Observational Methods
 Measure behavior by frequency,
intensity, duration, or latency
 Scatter plot
 “ABC” chart (documents observed
antecedents, behaviors, and
consequences)
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Scatter Plot
ABC Chart
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Outcomes of a Functional Assessment
1.
2.
3.
4.
5.
Describe the problem behavior
Identify the events, times, and situations that
predict when problem behaviors both occur
and do not occur
Identify the consequences that maintain a
problem behavior
Develop a hypothesis
Confirm the hypothesis using direct
observation
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Functional Analysis
 A functional analysis involves observing
behavior while systematically
manipulating environmental events
 A functional assessment includes
functional analyses, indirect assessment,
and direct observation
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Activity
 In small groups, discuss an individual
you currently support
 Discuss what you think is maintaining an
individual’s problem behavior
 What type of information do you have to
confirm this hypothesis?
 What other evidence do you need?
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PBS Planning
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PBS Plans Must be
a Good “Fit”
 Values of team members
 Resources available
 Skills and background of those
implementing the PBS plan
 Training identified as needed
 Use team based strategies to
identify interventions
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Team-based Brainstorming
 Bring functional behavioral assessment
information
 Set up flip chart paper for writing down
interventions
 Set aside time to brainstorm each part of
the hypothesis statement
 Do not judge ideas during brainstorming
 Go back later as a team and pick
interventions
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Logically Linking the Functional Assessment
to PBS Planning
(Adapted from O’Neill, et al., 1997)
Setting Event
Antecedent
(Trigger)
Problem
Behavior
Consequence
Change in work
schedule
No attention from
staff or peers
Pulls hair
when
someone is
nearby
Immediate
attention
Setting Event
Interventions
Antecedent
Interventions
Teach New
Skills
Consequence
Interventions
30
Logically Linking the Functional Assessment
to PBS Planning
(Adapted from O’Neill, et al., 1997)
Setting Event
Antecedent
(Trigger)
Problem
Behavior
Consequence
Change in work
schedule
No attention from staff
or peers
Pulls hair when
someone is
nearby
Immediate attention
Setting Event
Interventions
Antecedent
Interventions
Teach New
Skills
Consequence
Interventions
 Alert residential staff to
Provide one on one
staffing on days with
schedule changes
Teach person to
 Reduce attention for hair
initiate a positive
interaction with
picture schedule
pulls
 Reward person when he
successfully completes
time alone with no hair pulls
changes at work
 Rehearse changes
before work with his picture
schedule
Temporarily increase
attention on days when
changes occur
 Provide high levels of
staff attention and
structure activities that
encourage interaction
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Setting Event
Interventions
Antecedent
Interventions
Teach New
Skills
Consequence
Interventions
 Alert
Provide one
on one
staffing on
days with
schedule
changes
Teach
 Reduce
person to
initiate a
positive
interaction
with
picture
schedule
attention for
hair pulls
 Reward
person when
he
successfully
completes
time alone
with no hair
pulls
residential
staff to
changes at
work
 Rehearse
changes
before work
with his
schedule
Temporarily
increase
attention on
days when
changes occur
 Provide
high levels of
staff attention
and structure
activities that
encourage
interaction
32
Examples of Setting Event Interventions
 Minimize or eliminate the setting event
 Design interventions that are implemented
when setting events occur
--Neutralize the setting event
--Withhold or eliminate the antecedent
--Add more prompts for desirable behavior
--Increase the value of reinforcement for
desirable behavior
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Antecedent Interventions
 Avoid presentation of antecedent (verbal
demand statements)
 Modifying Tasks
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The way activity is completed
Functional activities
Compensate for skill deficits
Initially providing extra support
 Create high levels of predictability
 Offer choices
34
Teaching New Skills
 Identify a desirable behavior that will serve the
same function as the problem behavior
 This new behavior must be more efficient when
compared to the problem behavior
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Consequence Interventions
 Are important when teaching new skills (the
goal is to make the problem behavior inefficient
compared to new behaviors)
 Withdraw or terminate reinforcement
maintaining problem behavior (extinction)
 Withdrawing or terminating reinforcement can
result in an “extinction burst” (problem behavior
may increase temporarily before decreasing)
36
Examples of Consequence
Interventions
 Intervene early before problem
behaviors increase in intensity
(we often ignore early signs that are not as problematic
and respond to serious problems)
 Redirect person early in the chain
of problem behaviors
 Avoid engaging in coercive
interactions
37
Building a Positive Interaction Pattern
 Rapport building strategies
 Provide 4 positive statements for every
demand or request
 Deliver reinforcement to persons
immediately when you observe them
engaging in positive social behaviors
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Activity
Read this vignette and use the PBS
planning tool
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PBS Planning Tool
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Cycle of Positive Behavior Support
PCP
Curriculum
Functional
Assessment
Medical/
Health
Hypotheses: Global and Specific
Multicomponent Interventions
Data Analysis and Evaluation
Ineffective
Florida’s Positive Behavior Support Project-USF
Effective
Generalization/
Maintenance
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Effective PBS Plans
 Identify the full set of problem behaviors
 Focus on routines
 Document the escalating pattern of problem
behavior from lowest to highest intensity
 List all behaviors and indicate which behaviors
are maintained by the same function
 Implement plan across all relevant settings and
times
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Features of a Written PBS
Plan
 Identifying information, reasons for the
plan, person’s positive characteristics
 Description of the problem behavior(s)
 Summary of the hypothesis statement
 General description of interventions and
specific strategies in more detail
 Crisis prevention plan (as necessary)
 Group commitment (obtain signatures)
43
Implementing a PBS Plan
 Provide a timeline for implementing each
intervention
 Document the agreed upon dates for meetings
 Identify the individuals responsible for
implementing each intervention
 Spread responsibilities among team members
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Implementation Plan Example
Activity
Person Responsible
Date of
Completion
Functional Assessment
Interviews
Direct Observations
R. Freeman
T. Dolby
11/14/00-11/27
11/15/00
R. Freeman
R. Freeman
All Team members
11/16/00-11/17/00
12/2/00
12/3/00
Summary of Report
Brainstorming Session
PBS Plan Development
Develop materials
B. Smith
Schedule mentor sessions M. Brown
Secure extra staff support L. Kinley
Write scripts and
R. Freeman
Evaluation Plan
Meetings for review of dataAll team members
Collectors of data
B. Smith
Summarize data for meetings
R. Freeman
(Adapted from Horner, Albin, Sprague, & Todd, 2000)
12/11/00
12/11/00
12/14/01
12/15/00
1/14/01
Ongoing
Ongoing
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Enlarged Implementation Plan
Activity
Person Responsible
Functional Assessment
Interviews
R. Freeman
Direct Observations
T. Dolby
R. Freeman
Summary of Report
R. Freeman
Brainstorming Session All members
Date of
Completion
11/14/00-11/27
11/15/00
11/16/00-11/17/00
12/2/00
12/3/00
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Enlarged Implementation Plan
PBS Plan Development
Develop materials
Mentor sessions
Extra staff support
Write scripts
B. Smith
M. Brown
L. Kinley
R. Freeman
12/11/00
12/11/00
12/14/01
12/15/00
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Enlarged Implementation Plan
Evaluation Plan
Review of data
Data collectors
Summarize data for
Meetings
All members
B. Smith
R. Freeman
1/14/01
Observe dinner
twice/week
Weekly
(Adapted from Horner, Albin, Sprague, & Todd, 2000)
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Evaluating a PBS Plan
A PBS plan should result in…
 Decreases in problem behavior
 Increases in academic and social skills
 Positive lifestyle changes
49
Collect a Baseline of
Problem Behavior
50
Examples of Evaluation Measures
 Compare the frequency of problem behavior
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and appropriate behavior
Assess whether the person’s social skills have
increased
Observe number of positive interactions that
occur during key routines
Changes in the persons quality of life (access to
new resources, new friendships)
Assess level of satisfaction with the PBS plan
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Useful Tools for PBS
 Link to the Rehabilitation Research and
Training Center on Positive Behavior
Support Facilitator’s Guide:
http://www.fmhi.usf.edu/cfs/cfspubs/pbsgui
de/facilitatorguidepbs.htm
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For More Information
 Kansas Institute for Positive Behavior Support
(www.kipbs.lsi.ku.edu)
 Kansas University Center for Developmental
Disabilities - PBS Resources
(http://www.uappbs.lsi.ku.edu)
 Center on Positive Behavioral Interventions and
Support
(http://www.pbis.org)
 Rehabilitation Research and Training Center on
PBS (http://www.rrtcpbs.org)
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