Social Welfare Department
Clinical Psychological Service Branch
Central Psychological Support Service
Staff Training for ICCC
Topic: Managing Challenging Behavior in
Young CSN: Positive Approach
(Positive Behavior Support, PBS)
正面行為支援
Presentation Outline
Introduction
Functional Assessment (功能評估)
Interventions: Environmental
Arrangement
Interventions that Honor the Function of
the Behavior
Interventions that Do Not Honor the
Function of the Behavior
Challenging Behavior
“Behavior emitted by a learner that results
in self-injury or injury to others, causes
damage to the physical environment,
interferes with the acquisition of a new
skill, and/ or socially isolates the learner”
Doss & Reichle (1991)
Forms of Challenging
Behavior
Aggressions
Tantrums
Self-injuries
Hitting
Scratching
Kicking
Biting
Pinching
Throwing
objects
Crying
Screaming
Whining
Scratching
Biting
Pinching
Self-choking
Eye-gouging
Intervention Strategies
REACTIVE
ANTECEDENT
Intervention
consequences
implemented
after
behavior has
been produced
Intervention
implemented prior to
emission of
challenging behavior
in situations
associated with
challenging behavior
Traditional Reactive Strategies
Reinforcing Alternative Behaviors
Differential Reinforcement of Low Rate
Extinction
Timeout
Response Cost
Over-correction
Satiation
Punishment
Antecedent Strategies
Why Are They Advantageous?
 More effective than strategies that simply
serve to control or suppress behavior
 Opportunities can be generated
 Less disruptive to the environment than
reactive procedures
 Educative: new skills may be acquired in the
absence of frazzle(tedious and tiresome effort)
 Opportunities to interrupt chain of stimuli
associated with challenging behavior
 Do not have to deal with the behavior
Functional
Assessment
Functional Assessment
a process of determining the relationship
between
events
in
a
person's
environment and the occurrence of
challenging behaviors.
assumes that individuals with disabilities
behave in adaptive ways to ongoing
changes in their environment
(except those habitual behaviors that do
not have obvious functions or symptoms
of particular disorder)
Main Outcome of a
Functional Assessment
A description of
the challenging
behavior
An identified social
function or purpose
of the behavior
Identified setting
event(s) associated
with the behavior
Case 1
Behavior
 Mary hits other children during gross motor time when she
does not get her way
Functional Analysis
 Get tangibles
Setting Event
 Inadequate sleep, sickness
Other factors
 Limited verbal expression skills
 Lack of structure and rules in the gross motor area
 Overcrowding in the gross motor area
Case 1
Behavior Intervention Plan
 Teaching appropriate behavior to get what she wants
 Provide support and cues to use appropriate behavior
 Praising appropriate behavior
 Structure the GM area to eliminate the possibility of
engaging in the challenging behavior
 Involved speech therapist to teach him specific phrase and
sentence to express herself in the setting
 Discuss with parents about sleeping pattern to ensure
adequate sleep and develop good habit
 Pay more attention to child when she is sick
Case 2
Behavior
 Tom makes irrelevant and inappropriate comments during
story time
Functional Analysis
 Get attention
Setting Event
 Usually on Monday
 Sit at the back
Other factors
 Child has told teacher that his mother has favoritism
towards his younger brother
 The format of the story time allow limited student
participation
Case 2
Behavior Intervention Plan
 Increase student participation in story time and require
student to raise up hand before speaking
 Give him chance to do classroom duty and praise prosocial behavior
 Discuss with parents about sibling rivalry issue
 Expand interest that he can engage himself
 Teach him techniques to control himself and provide
reinforcement
 Seating arrangement to minimize opportunity to talk at
the back
Case 3
Behavior
 David throws temper tantrum when he is doing his
class-work in writing
Functional Analysis
 Avoid task
Setting Event
 Reprimand by parents the day before on homework in
writing
 Teasing by peer about his poor writing
Other factors
 Child has fine motor skills problem
 Parents are strict in demand of his writing skills
 Child easily felt anxious and is sensitive to comment
Case 3
Behavior Intervention Plan
 Recognize the physical signs that he is becoming anger.
Arrange quiet corner when he is distressed
 Teach him relaxation skills
 Practice communication skills of requesting for a break
and assistance
 Discuss with parents about parenting issues
 Peer mediating strategies – buddy program
 Seeking support from professional
 Curricular and environmental modification to facilitate
him learning in proper pace
Functional Assessment
Methods
Indirect Assessments
Direct Observation Strategies
Environmental Manipulation
Assessments
Indirect
Assessment
(Appendix C,D & E)
Indirect Assessment
 What exactly does the behavior look like?
 What do you think is the possible motivation/
function for behavior?
 What events/ situations predict the behavior?
 What does the child like and not like?
 How does the child communicate wants and
refusal?
 What are some other factors (medical, outside
school schedule) that may affect behavior?
Indirect Assessment
Setting Events
Conditions that occur concurrent
with problem behaviors or are
more distant in time and increase
the probability that challenging
behavior will occur.
Indirect Assessment
Setting Events
 Staff changes
 Medications were changed
 Slept fewer/ more hours than usual
 Show signs of illness
 Chaotic/ Demand situations
 Surprise visits from people
 Unexpected things occur
 Experienced a long waiting time
 Temperature of environment was too hot/cold
 Unpleasant environment (physical/ social)
 Reprimand by caregiver
 Was aggressed upon by another peer
Direct Observation
Strategies
(Appendix A & B)
Direct Observation
Strategies – ABC Charts
Antecedent
(前因)
Behavior
(行為)
Consequence
(結果)
Functional Analysis
(Appendix F & G)
Function of Challenging
Behavior
Obtain Desirable
Events
Attention
Tangible/
Sensory
Avoid/ Escape
Undesirable Events
Attention
Tasks/
Change/
Sensory
Environmental Manipulation
Assessments
What are they?
Controlled comparisons of at least two
different antecedents or two different
consequences that are hypothesized to
influence the emission of challenging
behavior
Why should they be implemented?
To clearly identify specific antecedents
and/or consequences influencing
challenging behavior that could not be
isolated during direct observation
Behavior
Intervention Plan
(Appendix H & I)
Interventions:
Environmental
Arrangement
Environment Arrangement
Goal: safe, easy-to-use, promoting
desired behavior and preventing
problems
Key Ingredients for Structuring
Your Program for Positive Behavior
 Create a physical arrangement that eases
management, promotes interaction, and
prevents problems.
 Establish program rules that help guide
behavior of children and adults.
 Utilize staff in an efficient and effective manner.
 Provide materials that promote attention and
persistence.
 Develop a daily schedule that establishes
transitions and routines.
Tips for Arranging Activity Areas
 Activity areas - distinct areas, separated by low
dividers that the teacher can easily see over
 Separate areas by using low barriers, tape on floor,
carpet, tables, shelving, room dividers.
 Label activity areas (e.g., a picture of children
playing with blocks with the word BLOCKS).
 Activity areas should be arranged so that quiet
activities are together (e.g., art, reading, and
listening to tapes).
Tips for Arranging Activity Areas
 Louder activity areas should be together (e.g.,
blocks, dramatic play)
 Separate quiet & active areas (e.g., cars & reading)
 Check traffic patterns between activity areas,
bathrooms, etc.
 Are they planned so that children can easily move
from one area to another?
 Activity areas need to be accessible to all children in
the room
 Limit the number of children in an activity area
 Quiet area should be provided for relaxation or quiet
time.
Sample Classroom Rules
 Share materials.
 Talk in a GENTLE voice.
 Listen to the teacher.
 Touch gently.
 Walk (not run) in the classroom.
General Rules for Materials
 Have a plan in place for those items which cannot
be shared (e.g., timer, list, necessary social skill
“May I play with the phone next?”).
 Adaptive equipment may be needed to help
children participate in all activities (e.g., clamps
to hold paper, page turner)
Utilizing Staff
Arrangement
 Zone vs. Child directed monitoring.
Responsibilities
 Each member of the staff should know what
he or she should be doing at any given time.
 All responsibilities related to paperwork,
teaching assignments, data collection,
materials preparation, etc., should be clearly
delineated.
 These responsibilities should be translated to
the daily schedule.
Staff Planning
Allocate sufficient time for:
planning individual or group activities.
preparing classroom materials. sharing
observations, information, and
strategies with each other, evaluating
the effectiveness of the activities and
strategies.
Communication
Staff Communication
Daily meetings (15 - 20 minutes)
attended by teaching staff provides an
opportunity to discuss:



events of the day
progress of individual children
strategies to make instruction more
effective plans for the future
Staff Communication
Weekly meetings attended by teaching
staff and consultant-specialists provides an
opportunity:


for specialists to present assessment data for
specialists to teach teaching staff therapeutic
or instructional techniques for individual
students
for the team to develop instructional plans
that target IEP goals in the context of
functional skills.
Scheduling Activities
 Schedule all activities including transitions, snack,
and play.
 Alternate “work” and “play” to build natural
rewards into your schedule.
 Order activities to reflect when they would occur
in the natural environment.
 Provide a variety of interesting activities.
Interspersing active and quiet activities and
utilizing changes in settings.
 Follow your schedule but be flexible.
 If you find yourself falling behind, change your
plans.
Scheduling Activities
Indicators of Disorganized Environment
Noise level
Staff placement
Schedule not followed
Poor organization of space
Transitions not planned
Children waiting
Peer-Mediated/Consequence
Strategies
Peer-Mediated Strategies
 Buddies or role models
Consequence Strategies
 Have the child ring a bell when they get to the
transitioning activity
 Have the child beat the buzzer when they
transition to another activity
 Have the child receive directions for the new
task by a novel method (e.g., off a tape recorder,
turning a picture over).
Rearranging the Environment
Physical Arrangement
 Low Barriers
 Space and density
 Similar activities
 Clearly defined areas
Staffing Patterns
 Zone vs. child directed
 Rotate children between activities
Materials
 Interesting & accessible
 Rotate Work &have extra batteries
Interventions that
Do Honor the
Function of the
Behavior
General Rule of using
Communicative Replacement
Don’t continue to reinforce the challenging
behavior.
Try to minimize the probability that a
challenging behavior occurs before that of a
socially acceptable behavior
If possible, select a communicative
alternative that has been learned by child
Determine how the behavior can be
maintain by the natural environment
Response Prompts
 Gestural prompt: Point to an untied shoe.
 Verbal prompt: Say, “Put your toys away.”
 Model prompt: Demonstrate how to put the
toothpaste on the toothbrush.
 Partial physical prompt: Touch a student's
hand to indicate that a sponge should be
picked up.
 Full physical prompt: Place a hand over the
student's hand and guide the spoon to the
student's and guide the spoon to the
student's mouth
Communicative Replacement
Teaching Rejecting
Rejecting
A socially acceptable act produced to
avoid contact with an undesired person,
object, or activity
When given particular vegetables at
lunch, Karen says “Don't want,” and
they are removed.
Steps for Implementation
 Identify the earliest possible point at which
individual attends to the approach of the
undesired event without engaging in challenging
behavior.
 Reinforce the absence of challenging behavior in
the presence of the undesired event.
 Prompt or model the desired communicative
alternative in the presence of the undesired event.
 Shape successively better approximations or
gradually reduce the learner's reliance on response
prompts.
 Ensure that rejecting is used conditionally.
Communicative Replacement
Teaching “Requesting a Break”
A socially acceptable request to withdraw
from an uncompleted task with the
expectation of resuming engagement
During a puzzle activity, Joanie touches
her “break” symbol indicating that she
needs a break.
During work, Beth raises her hand to
indicate that she needs a break
Steps for Implementation
 Determine the amount of engagement prior to an
escape attempt.
 Just prior to arriving at this point, release the child
from the task.
 Once challenging behavior has diminished, prompt
a request for a break at the critical point of
engagement.
 After a correct response, the child should be
immediately released to a break activity.
 Near the end of the designated break activity, it
may be necessary to have an inducement to get
back to work.
Communicative Replacement
Request an Alternative Activity
A socially acceptable act that specifies a
desire to engage in a different activity
While working on the computer, Leah
touches the symbol on her AAC device
for “t.v."
During painting, Cory holds up the top of
a play-doh container, indicating his desire
to change activities.
Steps for Implementation
The initial steps of this approach are
identical to requesting a break
The child may be taught to request one
of several explicit activities or a general
“can I do something else” response.
This strategy is often implemented
concurrently with efforts to teach
communicative request.
Communicative Replacement
Teaching “Requesting Assistance”
This strategy can be implemented when
the interventionist is certain that
providing unsolicited assistance reduces
emission of challenging behavior
During a cutting activity, Angie signs
“help” and her teacher comes over to
help her. When putting the dishes away
after dinner, Becky requests “I need help,
please.”
Steps for Implementation
Provide unsolicited assistance in
presence of a provoking activity.
-butin the absence of challenging behavior.
Just prior to delivering unsolicited
assistance, prompt a request.
Communicative Replacement
Teaching Request for Attention
 Sometimes individuals who escape activities are
more likely to engage if they have attention of
others while they engage in the less preferred
activity. If this is the case it will have been
demonstrated during the assessment process.
 During a group activity, Mary gestures for the
teaching assistant to “Come here” When a
teacher walks by, Frank pushes a button on his
communication device that says, “Stop and talk
to me.”
Steps for Implementation
Upon the approach of the activity, the
interventionist will offer their company
and will stay contingent on child
engagement in the unpreferred activity.
Once this strategy has resulted in a
greater likelihood of child engagement in
the activity, the teacher will begin to delay
the delivery of attention and instead
deliver a prompt to the individual to
produce a request for attention.
Interventions that Do
Not Honor the
Function of Behavior
Tolerance for Delay of
Reinforcement
 Teaching the child to
(a) stay engaged in a task/activity, or
(b) wait for a desired object for longer
periods of time.
Examples:


At the lunch table, the child begins to get
fidgety. Teacher says, “Two more bites.”
At storytime, Margaret starts to complain
that she wants to leave, the Teacher says,
“Four more pages.”
Steps for Implementation
 Identify the situation.
 Identify the shortest amount of time that the
child will wait before exhibiting behavior. (CTP)
 Choose a delay signal.
 Engage the child in the activity.
 Deliver delay signal prior to critical time period.
 Continue engagement for a short time longer.
 Deliver a safety signal and reinforcement
(e.g., release child from task, deliver requested object).
 Gradually increase time child has to wait between
signal and delivery of activity/object
Providing Choices
Choice making is a competency or skill
which is demonstrated when a child
selects a preference from among two or
more options.
Once a skill is established, choice
making can be used as an intervention
strategy to increase participation or to
reduce the likelihood of disruptive
escape and avoidance behaviors.
Steps for Implementation
 Identify a continuum of preferred/ nonpreferred
objects or activities.
 Determine whether it is acceptable for the child to
engage in one or both of the offered activities.
 Present choices.
Among Activities

Offering a choice between undesired activities often
decreases challenging behavior in those activities.
Within Activities

Offering choices between components of an
nonpreferred activity often decreases challenging
behavior.
Prespecified Reinforcers
Prespecifying the reinforcer means
that prior to engaging the child in
the target activity, the child is told or
shown what he/she will receive
when the task is finished. It is an
“if/then” statement.
Steps for Implementation
Identify items and events that have
reinforcing qualities.
Identify situations in which the child
engages in challenging behavior.
Present request along with prespecified
reinforcer.
Consequate appropriately
Preferred Items as Distractors
An intervention strategy in which a child
is given a preferred item during an
activity or event in which he or she
typically emits escape/avoidance
motivated challenging behaviors.
Pairing the preferred item with the
undesired activity or event is intended to
distract the child and decrease the
likelihood that he or she will engage in
challenging behaviors to escape.
Steps for Implementation
 Identify situations in which distractors may be
useful.
 Identify how long the child will tolerate an
activity before producing challenging behavior.
 Identify preferred items.
 Deliver distractor prior to engagement in
challenging behavior.
Examples
• Giving child a toy to play with while bathing
her.
• Letting a child listen to a tape recorder while
riding in the car.
High-Probability Requests
An intervention strategy that can be
implemented to increase children's
participation in activities that generate
escape-motivated challenging behavior.
High-probability and low-probability
requests must be chained together.
Steps for Implementation
Identify a set of high-probability requests
(Those responded to 80% or more)
Identify a set of low-probability requests.
(Those responded to 30% or less)
Ensure validity of Hi and Low P's
Implement Hi-P request
Deliver Low-P request
Collaborative Activities
Sharing the responsibilities
of the task or activity in
which a child typically
exhibits challenging
behaviors.
Steps for Implementation
 Identify critical activity or time period.
 Present offer to assist in undesired activity
 Identify activity
 Split the responsibilities of the task
 Prior to the child's engaging in challenging
behavior, present the task demand in a
collaborative fashion.
NOTE: This intervention is effective for those
children that engage in challenging behavior
to escape from an activity and obtain
attention.