Behavioral Consultation in
Your Child's School :
Improving Outcomes
Jane Barbin, Ph.D., BCBA
behavioraldirections@smartneighborhood.net
1
What is Behavioral Consultation?
• Professional guidance to and for individuals with
autism spectrum disorders and the educational,
vocational, residential, and family systems
supporting those individuals
• Focus is on using technology based in principles
of learning
2
Research-based Intervention
• Intervention focus is Applied Behavior Analysis (ABA)
• Extensive research supports effectiveness of ABA for
individuals with ASD
• Behavioral contingencies which lead to successful
consultation can be analyzed
3
Consultation: To Whom?
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•
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Parents
Extended family members
Caregivers
Instructional personnel
Related service providers
Administrators
Governing boards
4
Consultation: About what?
•
•
•
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•
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Instructional strategies
Skill acquisition
Challenging behavior
Motivational systems
Curricula
Organizational systems
5
Flawless Consulting
(Block, 2000)
Consultant
“A person in a position to have
some influence over an
individual, a group, or an
organization, but who has
no direct power to make
changes or implement
programs.”
Manager
“Someone who has direct
responsibility over the
action.”
6
Shared Assumptions
~though not sufficient~
•
Uses procedures with scientific backing
•
Consultant has adequate training and experience:
 BCBA / Autism SIG Consumer Guidelines
(listed by parents as factor much associated with success)
•
Sufficient economic resources (cost, materials, time)
•
Individual factors considered (cognitive state, dual
diagnosis)
7
Further…
• Behavioral consultants should be obligated to:
• Describe their credentials and experience
• Explain the intervention method in detail
• Take concurrent variables into consideration
• Describe the process for objective treatment evaluation
(e.g., effectiveness). How will success be measured?
Will data be collected?
8
Survey Questionnaire
“Factors Related to Successful Consultation”
Collected 2005-06
Respondents: 49 Consumers (Parents/ School Staff)
73 Providers
9 items using 5 point Likert scale rating
Examples: Research-based treatment, training, costs,
ease of implementation, generalization, data collection
Descriptive Data:
• 3 factors associated with success
• 3 barriers to success
• Open –ended section
9
Factors: Order of Importance (Consumers)
MOST
1.
Data Collection with data-based decisions
2.
Training: Ongoing, feedback
3.
Generalization
4.
Research-based procedures
5.
Cost/Fees
6.
Ease of implementation
7.
Sibling/Marital issues (shared duties, treatment
agreement, schedules)
8.
Immediacy of behavior change
9.
Agency variables (staff consent, regs, resources)
LEAST
10
Top 3 Factors Related to Success
5
4.5
Average Rating
4
3.5
3
2.5
Providers
Consumers
2
1.5
1
0.5
0
Data-Based
Decisions
Ongoing Training
Generalization
11
Factor #1-Data Collected/
Data-Based Decisions
• Basic assumption of behavioral intervention
• Both providers and consumers ranked this as
the #1 factor related to success
~The scientific study (of behavior) requires
precise measurement”
(Baer, Wolf, & Risley,1968)
12
Data Collection & DataBased Decision Making
Consumers:
• data collection can be overwhelming
• consultants stuck on taking data
Providers:
• would like data to play a more significant role
• shaping procedure, (do it, then team sees value)
13
Data collection
Data collection for behavior reduction & skill acquisition!
 Include use of data collection in IEP to measure
progress
 Operationalize all IEP goals and targeted behaviors
 Get all parties involved (SLP, OT, Teacher, 1:1)
 Interobserver reliability –ideal!
 Adds integrity, accuracy and ACCOUNTABILITY
14
DATA SAMPLE SHEET (Skill Acquisition)
Instructor: ___________________________________
Date: ______________________
IEP Goal/ Program Name: ________________________________
(Yes= independent
Targets
No= prompted or incorrect)
1
Y
2
3
Y
Y
N
Y
N
Y
N
Y
Y
Y
Y
Y
Y
Y
N
Y
Y
N
Y
Y
N
Y
N
Y
Y
N
Y
N
Y
N
Y
N
Y
N
Y
N
Y
Y
N
Y
N
Y
N
N
N
N
Y
N
Y
Y
Y
N
N
N
N
Y
Y
Y
N
N
N
N
Y
Y
Y
N
N
N
N
Y
Y
Y
N
N
N
N
N
Y
Y
Y
N
Y
N
N
N
10
Y
Y
Y
Y
9
N
N
N
N
Y
N
Y
Y
Y
N
N
N
N
Y
N
Y
Y
Y
N
N
N
N
Y
N
N
Y
Y
Y
Y
N
N
N
Y
Y
Y
Y
Y
N
N
N
Y
Y
Y
Y
8
N
N
N
7
Y
Y
Y
6
N
N
N
N
Y
Y
5
N
N
N
N
Y
N
N
N
4
Y
Y
TRIALS
N
Y
N
N
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Behavior Reduction DATA SHEET FOR ___________ Date:________________
Directions: Place tally marks in the column representing the time and behavior that occurred. List
times getting reinforcement in the appropriate column. Place a “0” if the behavior DID NOT occur.
Tantrums
Agg
Disrupt
SIB
SR
Time
oTantrums - stomping his feet, screaming, crying (record as separate instance if 2 sec. quiet in between)
oAggression - attempts or instances of pushing or grabbing others
oDisruption - forcefully hitting a surface or objects
oSelf-injurious behavior (SIB) - forcefully slapping his thigh area, chest or other body part with hand(s)
oSR - Times getting the back–up reinforcer
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IEP Goals/ Objectives
PROPOSED:
Provided with sensory preparation exercises/strategies throughout the
day, the student will attend for intervals of 15 minutes for 3 out of 5
days using teacher/parent/therapist observation.
REVISED:
Given a structured teaching environment, prompting, prompt fading and
reinforcement, the student will demonstrate appropriate on-task and
attending behaviors by not disengaging from the assigned task at
hand for more than 30 seconds for 4 out of 5 trials across 2
consecutive weeks using sample data collection.
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Factor #2-Training
Consumers:
•
school staff do not train parents
Providers:
•
need for step by step instruction guide
18
Training
• “…ongoing, hands on training (modeling, supervised practice, and
immediate verbal feedback) is needed.” (McClannahan &
Krantz,1993)
• Didactic procedures alone are insufficient (McClannahan & Krantz,
1993)
• …week long parent training series, …parents can effectively
implement strategies and teach others
(Symon, 2005)
•
“Parents and teachers require training in direct application for
individual child otherwise it becomes a bad game of telephone.”
(parent)
19
Training
“…the success of an intervention is dependent
upon not only its effectiveness but also upon its
precise delivery by a clinician and the
consistency with which parents implement that
treatment with all its essential features.”
Allen & Warzak (2000)
20
Training
• Best for consultant to identify training needs first, then
offer support but school must be willing
• Take collaborative role – trying to understand
school/class/teacher variables, adapt program as needed
• Set small goals and follow-up closely (email, repeat
visits, agenda, offer help)
• Recognize school efforts and strengths in that
environment to build team work
• Follow through and consistency are key!
21
Factor #3-Generalization
Stokes and Baer (1977)
… the occurrence of relevant learned behavior
under different non-operant conditions.
Vary noncritical dimensions of antecedents and
accept a wide range of responses.
22
Generalization
Consumers:
•
“My son has learned to generalize his language skills.”
Providers:
• planning for generalization (e.g., fading Sr, training
caregivers);
• no generalization from school to home as a problem
23
Generalization
Does the intervention result in a better quality of
lives for the families? (Provider Response)
• Plan to intervene and program in natural setting from
the start; settings other than school can be implemented
by all providers
24
Only Research-based Interventions
• NYSDOH Early Intervention Program (1999)
…recommends ABA as primary treatment
approach
• Heflin and Simpson (1998)
…one of most efficacious and controversial
interventions (controversy relates to exclusion of
other methods, intensity required, etc.)
• ABA is also controversial locally and expensive.
Access to quality services is often parent-driven
and a grassroots effort.
25
Scientific vs. Nonscientific Approach
• ABA is a science. Science relies on direct and objective
evaluation
• Uses operational definitions
• Compares effects to pre-treatment (baseline) occurrence
of behaviors using systematic measurement
• Considers alternative explanations / confounds
• Replicates results (e.g., reports are from different people)
and presents the results in peer reviewed journals
26
Only Research-based Interventions
• ABA Standards – SIG Guidelines
• Association for Science in Autism Treatment
(ASAT) and Organization for Autism Research
(OAR)
• Both parties indicated “highly important,” yet
consumers describe ABA providers as
“rigid/inflexible”
• Providers spoke of, “Lack of buy-in,” resistance
to ABA, competing programs
• Consumer protection is compromised
27
Only Research-based Interventions
• Realistic expectations
• Commitment to systematic intervention
• Identification / agreement of functional goals
28
Only Research-based Interventions
• Consumers:
• Need to implement “all” behavioral applications,
need for language goals, be “open-minded”
• Providers:
• Success: Shared philosophy-”Buy-in”
• Barrier: Disagreement on philosophy
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Only Research-based : ABA Practice
• General need for clarity in field to increase buy-in
What ABA/ behavioral consultant is, what exactly they do?
• Behavior Analyst Certification Board Guidelines for Responsible
Conduct For Behavior Analysts© (2004)
“When behavior analysts provide assessment, evaluation, treatment,
counseling, supervision, teaching, consultation, research, or other
behavior analytic services to an individual, a group, or an
organization, they use language that is fully understandable to the
recipient of those services. They provide appropriate information prior
to service delivery about the nature of such services and appropriate
information later about results and conclusions.”
30
Only Research-based : ABA Practice
• We use the same words to mean many
different things
• Once-size-fits-all terminology (Ex: “intensive,”
“data-based”)
• Behavioral “sects” – VB, PBS, EIBI, Lovaas
• Articulate specific treatment philosophy and
parameters
• Assessment protocol – defining treatment in
relation to individual needs and environments
31
Only Research-based : ABA Practice
• Social significance of goals, social
appropriateness of procedures, and
social importance of effects.
(Baer, D.M., Wolf, M.M., Risley T.R., 1968)
• Ultimate goal: Life in the least restrictive
environment with the least amount of
support.
(Bannerman, Sheldon, Sherman, & Harchik, 1990)
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What are my child’s learning needs?
• Seek assistance from a qualified professional (e.g., Board
Certified Behavior Analyst, Licensed Psychologist, Speech
Pathologist).
• Conduct indirect (e.g., parent/school staff interview) and direct
(e.g., school observation) assessments
• Operationally define strengths and weaknesses of current
educational placement and alternatives
• Is the class size/teaching method appropriate?
• Is the student engaging in problem behaviors?
• Staff training and experience
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Learning Needs –cont.
• It is often helpful to obtain a written report with recommendations
based on assessment results
• Share recommendations with the school team; seek advocacy and
support when convening IEP team; integrate recommendations into
IEP
• Provide ongoing support to the school team to facilitate
implementation of recommendations
• Training in how to address challenging behaviors.
• Providing a review of I.E.P. goals/short-term objectives with needed
modifications and additions
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Following Assessment
• Is a change in school placement necessary?
It is an IEP team question.
• Possible Benefits of Placement Change
• A program that more closely meets the student’s learning needs
• Improved student academic progress
• Access to more appropriate and effective teaching methodology
• Reduced challenging behaviors
• Potential Disadvantages
• Tuition for alternative placement
• Travel
• Removal from established peer group
• Determine if the current school placement is able, willing and can agree
(“consents”) to implement proposed recommendations.
35
Agency Variables
• Staff roles/ assent, limited resources & state regs
• Responsibility and authority of consultant
• Leader? Colleague? Team member? Separate roles of
consultant and manager
• Does s/he make suggestions or give directions?
• Does s/he have agreement amongst key participants?
• Models of consultation: individual, classroom-wide, schoolwide, district-wide
(Putnam, Handler, Rey & McCarty, 2005)
36
Collaboration and Communication
Consumer
Provider
+ Open
Honest
Ongoing
Written
+ Feedback system
Accessibility
Schedule
- Untimely
Vague
- Poor communication
Consumer 51% Provider 41% state lack of
collaboration / communication leads to problems
Weiss (1991)… arranging /collaborating with professionals is #1 stressor
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Clarifying Expectations
• Do not assume expectations are self-evident,
understood, or shared
• “…get all of the expectations out on the table…”
• “…real investment of time and effort up front…”
Covey (1989)
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“The road to success is always
under construction.” (unknown)
• Data-based decisions, ongoing training, and planning for
generalization are key to your child’s progress.
• Contracting can assist both parties and facilitate
communication. Keep written, organized records
• Maintain open communication whenever possible
39
Organizations / Resources
•
Autism Special Interest Group of ABA. www.autismsig.org; See the “Autism SIG
Consumer Guidelines for Identifying, Selecting and Evaluating Behavior Analysts
Working with Individuals with ASD.”
•
The Association for Behavior Analysis (ABA) – www.abainternational.org; phone: (269)
492-9310. This organization hosts an annual conference and parent attendance is
encouraged.
•
The Association for Science in Autism Treatment (ASAT) – www.asatonline.org; phone:
207-253-6008. This organization’s mission is to disseminate only scientifically sound
assessment and treatment information.
•
Behavior Analyst Certification Board (BACB) – www.bacb.com; This organization
promotes a national and international certification process for behavior analytic
practitioners. A database of certified practitioners is maintained on the site.
•
Behavioral Directions, LLC – www.behavioraldirections.com; See “Resource” page for
links to other organizations, references, recommended reading, etc.
•
Organization for Autism Research (OAR) – www.researchautism.org; Hosts a research40
based conference annually in Northern Virginia.