behavior assessment and planning for persons with asd...large opportunities. – naps – sleepy...

6152017

1

Behavior Assessment and

Planning for Persons with

ASD

Bruce E Davis PhD

Pennsylvania Autism Training Conference

June 8 2017

DRAFT

Objectives

bull Approach behavior change planning for persons with ASD as a problem solving practice within a system of individualized support

bull Define variables that must be considered in a behavioral assessment including

ndash Contextual vulnerabilities

ndash Skills vulnerabilities

ndash Contributing conditions

ndash Situational antecedents

ndash Functional outcomes

bull Discuss particular challenging behavior formulations for persons with ASD and identify appropriate strategies for a behavior change plan

6152017

2

Challenging Behavior

bull What Is Challenging Behavior

ndash Doing something that damages relationships

ndash Yelling property destruction physical aggression or selfmdashinjury

ndash Interferes with opportunities for a satisfying life

bull The Costs of Challenging Behaviors

ndash Relationships

ndash Opportunities for work

ndash Access to recreation

ndash Housing options

ndash Personal freedom

DRAFT Pennsylvania Autism Training Conference

Misconceptions

bull Challenging behavior is caused by ASD (Diagnostic Overshadowing)

bull ldquoHe knows what hersquos doingrdquo

bull There is a single cause for challenging behavior

bull Misconceptions GUARANTEE failure


6152017

3

Proactive v Reactive

bull Whatrsquos Going On

bull Reactive strategies

ndash Focus on risk management rather than supports

ndash Increases

bull Use of psychoactive medication

bull Calls to the police

bull Incarceration

bull Psychiatric hospitalization

bull Punitive behavioral procedures

bull Negative outcomes

bull Proactive strategies

ndash Start with behavior assessment

ndash Focus on producing positive outcomes

ndash Challenging behavior is a small element in a larger pattern of events conditions and

variables

The Circle of Life

6152017

4

The Rock

bull For 25 years Mom was Billrsquos

rock

bull She helped him through

everything each day

bull With a little help from a day

activity program

bull She stuck with him come what

may


Bill ndash Making a Change

bull Then the forecast wasnrsquot sunny

one day

bull Bill was leaving his rock

bull He did as he was asked and

simply walked away

bull Mom went back home to her

fears and tears


6152017

5

Getting There

bull When he got there all seemed just fine

bull But Bill was not a fan of change

bull His helpers worked to help him settle

bull But everything still felt strange

6152017 DRAFT Pennsylvania Autism Training Conference

I Have No Words

bull Everything happened so fast

bull All Bill could do was stand and listen

bull He absorbed it all like a champ

bull Though occasionally his eyes would glisten


6152017

6

Mamarsquos Son

bull He didnrsquot say much but he cried for days

bull He missed his mother dearly

bull She visited him each weekend and more

bull But to him it felt like yearly


End of an Era

bull This change isnrsquot easy for Mama either

bull A host of emotions swirl

bull Were it not for her failing health

bull Shersquod keep him to the end of the world


6152017

7

Roomies

bull The roomie situation was dicey

bull lsquoCause not much thought was given

bull To the fact that the roommates liked loud music

bull But Bill liked quiet livinrsquo

6152017


Billrsquos House Party

bull On Saturday someone yelled ldquoLetrsquos Dancerdquo

bull And from there the party was on

bull Roommate Sam ldquoTurned up the Radiordquo

bull But Bill didnrsquot sign his Autograph to that piercing song


6152017

8

A Perfect Storm`

bull On top of that the staff were talking an laughing

bull Nobody was holding back

bull You hadnrsquot heard a noise like that

bull Since your old Van Halen 8-track


The Come Apart

bull And thatrsquos when the come-apart started

bull Bill screamed to drown the sound

bull He covered his ears and moved to the corner

bull He sank his teeth into his hand and flopped to the ground


6152017

9

Thank God for DSPs

bull Then his loyal staff stepped in

bull They held him close to end the fight

bull They shuttled him off to the quiet of his room

bull And there he remained for the night


Full Circle

bull My friends so goes the circle of life

bull The natural order of things

bull ASD doesnrsquot make life easy

bull But each end leads to new beginnings


6152017

10

Fill-in-the-Blanks for Bill

Contextual Vulnerabilities

Skill Vulnerabilities

Contributing Conditions

Situational Antecedents

Behavioral Output

Functional Outcomes

Background

Contextual

Vulnerabilities


6152017

11

Whatrsquos Missing



Building



6152017

12

Triggers



Whatrsquos Happening

Behavioral Output


6152017

13

Payoff

Functional Outcome


Stretch Break

bull Summary Before you intervene understand

bull Behavior can be complex

ndash Contextual Vulnerabilities

ndash Skill Vulnerabilities

ndash Contributing Conditions

ndash Situational Antecedents

ndash Behavioral Output

ndash Functional Outcome

bull Now what do you do Come up with a planhellip

6152017

14

Positive Behavior Supports (PBS)

bull Americans with Disabilities Act

(ADA)

bull Reasonable accommodations

bull Prevention strategies for

challenging behavior

bull Examples

ndash Ensuring access to opportunities

for social activity

ndash Family contact in accord with the

personrsquos wishes

PBS Strategies

bull Consistent Daily Life Routine - Putting

forth extra effort to ensure that daily

expectations and transitions occur in a

reliable order

bull Visual Prompting ndash Constructing the

daily schedule with pictures or icons

representing each activity

6152017

15

Accommodations in PBS

bull Non-contingent Reinforcement (NCR) ndash Allowing a person unfettered access to activities that they enjoy

bull Neutralizing Routines ndashEssentially itrsquos meeting a need before it becomes a need Examples include ndash Frequent snacks ndash some people benefit from

smaller eating opportunities rather than fewer large opportunities

ndash Naps ndash Sleepy people are more irritable A nap may ldquoneutralizerdquo this irritability

ndash Sensory stimulation ndash Providing opportunities for people to meet the need for visual auditory tactile or vestibular stimulation throughout the day

More PBS

bull Priming ndash Giving advance notice of an

upcoming activity or transition to

prepare the person and review relevant

expectations

bull Instructional Modifications ndash Changing

the way requests are made to increase

the likelihood of a positive response

6152017

16

First ndash Then Priming

First Then


Putting a Do with a Donrsquot

Replacement Skill

bull Replacement skills serve the same functional outcome as the challenging behavior

bull Joe signs ldquogordquo when at a place he doesnrsquot want to be

Alternative Skill

bull Alternative skills are promoted in place of the challenging behavior but donrsquot exactly serve the same functional outcome

bull Joe relaxes himself when in places he doesnrsquot want to be


6152017

17

Teaching Strategies

bull Shaping ndash rewarding behavior as it gets closer and closer to the complete skill you want someone to do ldquoBreak it Downrdquo

bull Reinforcement ndash Giving a person something they want (reinforcing) when they do the replacementalternative behavior ldquoIf you like it reward itrdquo

bull Role PlayingModeling ndash Role playing provides a way for a person to practice new skills ldquoBe the changerdquo

Therapeutic Strategies for Responding

to Challenging Behavior

ndash Extinction - Removal of reinforcement for challenging behavior Ex minimizing attention to a challenging behavior

ndash Redirection ndash Reminding the person of replacement or alternative skills he or she has learned to deal with difficult circumstances

ndash Response cost ndash Removing a privilege or preferred possession after the occurrence of a challenging behavior

ndash Time Out ndash Requiring the person to go to an area away from others following a challenging behavior for a specified period of time

6152017

18

Safety Procedures

bull Plans often contain instructions on what to do if the plan isnrsquot working and the personrsquos behavior escalates to a level that the situation becomes unsafe

ndash Blocking ndash Blocking a challenging behavior without controlling the personrsquos limbs

ndash Manual restraint ndash Holding a personrsquos limbs

ndash Protective equipment ndash Helmet gloves or other device that doesnrsquot completely restrict movement

ndash Mechanical restraint ndash Using a device to restrict movement of a body part

ndash Other restrictions ndash Preventing access to items or environments

Cautions Regarding ASD and ANY Form of

Restraint

bull Restraint may serve sensory function

bull May reinforce behavior for person with ASD

bull Benefit ndash Risk Analysis

bull Non-Contingent Reinforcement

bull Restraint not limited to physical procedures

6152017

19

Freer Living

bull Generalization and Independence

ndash Less reinforcementprompting ndash Behavior change

plans involve support persons providing reinforcement and prompting The fewer things support persons have to do the more independent the person becomes

ndash Reducing reliance on safety interventions ndash As a person progresses he or she should require less use of safety interventions

ndash Exposurereducing restrictions ndashFor example try taking the person to a place he or she couldnrsquot previously go because of his or her challenging behavior

ndash Reducing psychotropic medication ndash When a person makes improvements in behavior they may not require as much psychotropic medication if their psychiatrist agrees

Behavior Change Plans

bull Require consent of person or

legal representative

bull Approvals may be needed

6152017

20

Back to Bill

bull Pair up and discuss Billrsquos ldquoCircle

of Liferdquo

bull What recommendations would

you make for him

Fragile X Syndrome

bull Marked by long-face and

protruding ears large phallus

bull 13 have co-occurring ASD

bull Contextual vulnerability

bull Sensory sensitivity high


6152017

21

Contact

Bruce E Davis PhD

TN Department of Intellectual and Developmental Disabilities

Director of Behavioral and Psychological Services

(615) 852-1194

Brucedavistngov


Resources

Baladerian NJ Coleman TF and Stream J (2013) Abuse of people with disabilities Victims and their families speak out Spectrum Institute Disability and Abuse Project wwwdisabilityandabuseorg

Charlot L Abend S Ravin P Mastis K Hunt A Deutsch C Non-psychiatric health problems among psychiatric inpatients with intellectual disabilities J Intellect Disabil Res 2011 Feb55(2)199-209 doi 101111j1365-2788201001294x PubMed PMID 20546095 PubMed Central PMCID PMC3646333 Link to article on publishers site Durand M (1998) Sleep better Baltimore Brookes Publishing Company Esbensen A J (2015) Sleep problems and associated comorbidities among adults with Down syndrome Journal of Intellectual Disability Research 60(1) 68-79 doi 101111jir12236 Fletcher R Barnhill J amp Cooper SA (Eds) (2016) Diagnostic Manual ndash Intellectual Disability ndash Second Edition (DM-ID 2) A Textbook of Diagnosis of Mental Disorders in Persons with Intellectual Disability Kingston NY NADD Press

Flynn AG (2012) Fact or Faith On the Evidence for Psychotherapy for Adults With Intellectual Disability and Mental Healt h Needs Current Opinions in Psychiatry 2012 25(5)342-347

Griffiths D Gardner W and Nugent J Eds(1999) Behavioral supports Individual centered interventions A multimodal functional approach NADD Press 294 pages Harvey EA Metcalfe LA Herbert SD and Fanton JH (2011) The role of family experiences and ADHD in the early development of oppositional defiant disorder Journal of Consulting and Clinical Psychology 79(6) 784ndash795 doi 101037a0025672


6152017

22

Resources

Human Services Research Institute (HSRI) and National Association of State Directors of Developmental Disabilities Services (NASDDDS) (2015) Adult Consumer Survey Final Report 2013-2014

Kahn M Fridenson S Lerer R Bar-Haim Y and Sadeh A (2014) Effects of one night of induced night-wakings versus sleep restriction on sustained attention and mood a pilot study Sleep Medicine15(7) 825-32

Kamphuis J Meerlo P Koolhaas JM and Lancel M (2012) Poor sleep as a potential causal factor in aggression and violence Sleep Medicine Apr 13(4) 327-34

Kendall K amp Owen M (2015) Intellectual disability and psychiatric comorbidity Challenges and clinical issues See more at httpwwwpsychiatrictimescomcomorbidity-psychiatryintellectual-disability-and-psychiatric-comorbidity-challenges-and-clinical-issuessthashdHzlhHmhdpuf

Laraway S Snycerski S Michael J and Poling A (2003) Motivating operations and terms to describe them Some further refinements Journal of Applied Behavior Analysis 36 407ndash414 Number 3 (Fall 2003)

Laraway S Snycerski S Olson R Becker B and Poling A (2014) The Motivating operations concept Current status Psychological Record DOI 101007s40732-014-0080-5

Resources

Lovett Herb (1996) Learning to listen Positive approaches and people with difficult behavior Brookes Publishing Co 1996 LotfizadehADEdwardsTLRednerRampPolingA(2012a) Motivating operations affect stimulus control a largely overlooked phenomenon in discrimination learningBehavior Analyst 35 89ndash100

May M (2011) Aggression as positive reinforcement in people with intellectual disabilities Research in Developmental Disabilities 32(6) 2214-2224

McGlinchey EL Talbot LS Chang KH Kaplan KA Dahl RE amp Harvey AG (2011) The effect of sleep deprivation on vocal expression of emotion in adolescents and adults SLEEP 34 (9) 1233-1241 Mevissen L de Jongh A (2010) PTSD and its treatment in people with intellectual disabilities A review of the literature Clinical Psychology Review Apr 30(3) 308-16 doi 101016jcpr200912005 Epub 2009 Dec 13

Reiss S (2010) Self-hugging Believing that your values can make others happy httpswwwscribdcomdocument189185898Self-Hugging-Believing-Your-Values-Can-Make-Others-Happy

Rooker G W DeLeon I G Borrero C S W Frank-Crawford M A amp Roscoe E M (2015) Reducing ambiguity in the functional assessment of problem behavior Behavioral Interventions  Theory amp Practice in Residential amp Community-Based Clinical Programs 30(1) 1ndash35 httpdoiorg101002bin1400

Schieve LA Gonzalez V Boulet SL et al Concurrent medical conditions and health care use and needs among children with learning and behavioral developmental disabilities National Health Interview Survey 2006-2010 (2012) Research in Developmental Disabilities33(2)462-76

Whelan R amp Barnes-Holmes D (2010) Consequence valuing as operation and process a parsimonious analysis of motivationThe Psychological Record 60 337ndash354

6152017

2

Challenging Behavior

bull What Is Challenging Behavior

ndash Doing something that damages relationships

ndash Yelling property destruction physical aggression or selfmdashinjury

ndash Interferes with opportunities for a satisfying life

bull The Costs of Challenging Behaviors

ndash Relationships

ndash Opportunities for work

ndash Access to recreation

ndash Housing options

ndash Personal freedom


Misconceptions

bull Challenging behavior is caused by ASD (Diagnostic Overshadowing)

bull ldquoHe knows what hersquos doingrdquo

bull There is a single cause for challenging behavior

bull Misconceptions GUARANTEE failure


6152017

3





ndash Increases



bull Incarceration








variables

The Circle of Life

6152017

4

The Rock


rock


everything each day


activity program


may




one day



simply walked away


fears and tears


6152017

5

Getting There






I Have No Words






6152017

6

Mamarsquos Son






End of an Era






6152017

7

Roomies





6152017








6152017

8

A Perfect Storm`






The Come Apart






6152017

9

Thank God for DSPs






Full Circle






6152017

10






Behavioral Output

Functional Outcomes

Background

Contextual

Vulnerabilities


6152017

11

Whatrsquos Missing



Building



6152017

12

Triggers




Behavioral Output


6152017

13

Payoff

Functional Outcome


Stretch Break










6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

3





ndash Increases



bull Incarceration








variables

The Circle of Life

6152017

4

The Rock


rock


everything each day


activity program


may




one day



simply walked away


fears and tears


6152017

5

Getting There






I Have No Words






6152017

6

Mamarsquos Son






End of an Era






6152017

7

Roomies





6152017








6152017

8

A Perfect Storm`






The Come Apart






6152017

9

Thank God for DSPs






Full Circle






6152017

10






Behavioral Output

Functional Outcomes

Background

Contextual

Vulnerabilities


6152017

11

Whatrsquos Missing



Building



6152017

12

Triggers




Behavioral Output


6152017

13

Payoff

Functional Outcome


Stretch Break










6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

4

The Rock


rock


everything each day


activity program


may




one day



simply walked away


fears and tears


6152017

5

Getting There






I Have No Words






6152017

6

Mamarsquos Son






End of an Era






6152017

7

Roomies





6152017








6152017

8

A Perfect Storm`






The Come Apart






6152017

9

Thank God for DSPs






Full Circle






6152017

10






Behavioral Output

Functional Outcomes

Background

Contextual

Vulnerabilities


6152017

11

Whatrsquos Missing



Building



6152017

12

Triggers




Behavioral Output


6152017

13

Payoff

Functional Outcome


Stretch Break










6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

5

Getting There






I Have No Words






6152017

6

Mamarsquos Son






End of an Era






6152017

7

Roomies





6152017








6152017

8

A Perfect Storm`






The Come Apart






6152017

9

Thank God for DSPs






Full Circle






6152017

10






Behavioral Output

Functional Outcomes

Background

Contextual

Vulnerabilities


6152017

11

Whatrsquos Missing



Building



6152017

12

Triggers




Behavioral Output


6152017

13

Payoff

Functional Outcome


Stretch Break










6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

6

Mamarsquos Son






End of an Era






6152017

7

Roomies





6152017








6152017

8

A Perfect Storm`






The Come Apart






6152017

9

Thank God for DSPs






Full Circle






6152017

10






Behavioral Output

Functional Outcomes

Background

Contextual

Vulnerabilities


6152017

11

Whatrsquos Missing



Building



6152017

12

Triggers




Behavioral Output


6152017

13

Payoff

Functional Outcome


Stretch Break










6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

7

Roomies





6152017








6152017

8

A Perfect Storm`






The Come Apart






6152017

9

Thank God for DSPs






Full Circle






6152017

10






Behavioral Output

Functional Outcomes

Background

Contextual

Vulnerabilities


6152017

11

Whatrsquos Missing



Building



6152017

12

Triggers




Behavioral Output


6152017

13

Payoff

Functional Outcome


Stretch Break










6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

8

A Perfect Storm`






The Come Apart






6152017

9

Thank God for DSPs






Full Circle






6152017

10






Behavioral Output

Functional Outcomes

Background

Contextual

Vulnerabilities


6152017

11

Whatrsquos Missing



Building



6152017

12

Triggers




Behavioral Output


6152017

13

Payoff

Functional Outcome


Stretch Break










6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

9

Thank God for DSPs






Full Circle






6152017

10






Behavioral Output

Functional Outcomes

Background

Contextual

Vulnerabilities


6152017

11

Whatrsquos Missing



Building



6152017

12

Triggers




Behavioral Output


6152017

13

Payoff

Functional Outcome


Stretch Break










6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

10






Behavioral Output

Functional Outcomes

Background

Contextual

Vulnerabilities


6152017

11

Whatrsquos Missing



Building



6152017

12

Triggers




Behavioral Output


6152017

13

Payoff

Functional Outcome


Stretch Break










6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

11

Whatrsquos Missing



Building



6152017

12

Triggers




Behavioral Output


6152017

13

Payoff

Functional Outcome


Stretch Break










6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

12

Triggers




Behavioral Output


6152017

13

Payoff

Functional Outcome


Stretch Break










6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

13

Payoff

Functional Outcome


Stretch Break










6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

14



(ADA)




bull Examples


for social activity


personrsquos wishes

PBS Strategies




reliable order




6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

15







More PBS




expectations




6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

16


First Then



Replacement Skill



Alternative Skill




6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

17

Teaching Strategies










6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

18

Safety Procedures








Restraint






6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

19

Freer Living











6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

20

Back to Bill


of Liferdquo


you make for him

Fragile X Syndrome







6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

21

Contact

Bruce E Davis PhD



(615) 852-1194

Brucedavistngov


Resources






6152017

22

Resources







Resources








6152017

22

Resources







Resources








behavior assessment and planning for persons with asd...large opportunities. – naps – sleepy...

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