managing the behavior of children with autism in inclusive classrooms

8/2/2007 1

Managing the Behavior of Managing the Behavior of Children with Autism in Children with Autism in

Inclusive ClassroomsInclusive Classrooms

Brian A. Boyd, Ph.D.Frank Porter Graham Child Development Institute

University of North CarolinaInclusion Institute, Chapel Hill, NC

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Overview of PresentationOverview of Presentation

Characteristics of Autism & Problem BehaviorManaging Problem BehaviorPreventing problem behaviorReplacing problem behaviorResponding to problem behaviorSummary & Questions

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What is Autism?What is Autism?Autism is a neurodevelopmental disorder Autism is the second most common developmental

disability4-5 times more prevalent in boys than girlsOccurs on a behavioral continuum 75-80% of individuals have mental retardation 15-20% have average or above average intelligence

IQ HI

LO

SymptomsMild

Severe

AgeDimensions of Autism

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Characteristics of AutismCharacteristics of Autism

Social Communication Repetitive Behavior

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Types of Problem Behavior Types of Problem Behavior Associated with AutismAssociated with Autism

Social DifficultiesEscape/refuse social interactionInappropriate initiation strategiesCommunication DifficultiesRepetitive question askingInappropriate comments to strangersRepetitive and/or Problem BehaviorRepetitive hand flapping or object useAggression or SIB

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Usual Intervention StrategiesUsual Intervention Strategies

Context

Observable Behaviors

Characteristics of Autism


8/2/2007 Division TEACCH 7

Re-thinking Problem Behavior in Re-thinking Problem Behavior in AutismAutism

•Not socially interacting

•Lack of social motivation

•Aggressive towards peers

•Lack appropriate social initiation strategies


Re-thinking Problem Behavior in Re-thinking Problem Behavior in AutismAutism

•Need sensory input

•Repetitively rocks or hand flaps

•Repetitively dumps or pours objects

•Lack appropriate pretend play skills

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What Makes Inclusion Difficult for What Makes Inclusion Difficult for Children with Autism?Children with Autism?

Peer interaction

Learning via peer modeling

Emphasis on verbal communication

Environmental distractions

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What Makes Inclusion Possible for What Makes Inclusion Possible for Children with Autism?Children with Autism?

Our ability to put the appropriate supports into place

Our ability to manage problem behavior

Respond

Replace

Prevent

Managing Problem Behavior Pyramid

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Preventing Problem BehaviorPreventing Problem Behavior

1. Arrangement of Classroom Environment

2. Predictability of Classroom Activities

3. Appropriate Behavior Communicates

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What is Classroom What is Classroom Arrangement?Arrangement?

Physical set-up / organization of the classroomIs the classroom set-up in a manner that cues

appropriate behavior?Availability of appropriate classroom

materials and toysAre materials & toys developmentally appropriate?Learning environmentAre distractions minimized & environment

engaging?

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Things to Think About When Things to Think About When Physically Arranging the Physically Arranging the

ClassroomClassroomCharacteristics of the child What are his / her social, communication, & play skills? Is the classroom structured for the child who has the

most intense needs?Well-defined activity centers Physical boundaries? Additional centers (e.g. sensory, independent work)?Availability of developmentally and age-

appropriate play materials Cause and effect toys or ones that are easier to

manipulate? Sensory-based toys?

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Additional Questions to Additional Questions to ConsiderConsider

Physical Environment & Classroom StructureIs there a fluid traffic pattern in the classroom?Does the classroom have learning centers?Is there structure and organization for seated

activities?How structured is the unstructured play and

physical activity?Is there adequate teacher supervision? (e.g.

teacher-to-child monitoring; zone monitoring)?

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Additional Questions cont’dAdditional Questions cont’d

Toys and MaterialsAre the toys and materials

developmentally appropriate?Are there enough toys and materials?Are toys and materials organized and

accessible to the children?Are the children’s preferences included

in the choice of toys and materials?

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DistractionsAre distractions kept to a minimum (e.g.

phones, intercom, and teacher traffic)?Are learning areas visually distracting to

the children? Is there an appropriate level of noise in

the classroom?

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Learning EnvironmentAre learning opportunities organized

and structured throughout the day?Does the teacher have a daily lesson

plan? If so, is the plan followed?

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What is Classroom What is Classroom Predictability? Predictability?

Classroom rituals & routinesHow predictable are they?How can we make them more predictable?

Classroom schedulesAre classroom daily schedules available

(“between-activity” schedules)?Are activity schedules available (“within-

activity” schedules)?

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Rituals, Routines and Challenging Rituals, Routines and Challenging BehaviorsBehaviors

Rituals and routines (R & R) provide stability and consistencyR & R communicate values such as

friendship, caring, or responsibilityR & R serve as rule remindersR & R create a sense of community

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Using Rituals and RoutinesUsing Rituals and Routines

Transition times Hello/Good-bye SongAs a rule reminderCriss-Cross ApplesauceTimes of crisisBreaking the coercive pattern & redirectionAs often as you wantFun!

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Building Routines:Building Routines:First-Then Contingency SystemsFirst-Then Contingency Systems

First ThenFirst Then

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SchedulesSchedules

Daily schedules should provide consistency for the children

Daily schedules should follow a “natural ebb and flow” to encourage appropriate behavior

Daily schedules should become “routine” and predictable for the children (Colvin & Lazar, 1997).

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Daily Visual Schedules Daily Visual Schedules “Between Activity”“Between Activity”

Photographic or picture schedules provide concrete, visual cues of the scheduled routine (Massey & Wheeler, 2000).

Changes to the schedule or special events (field trip, visitor, substitute teacher) require specific photos or pictures to cue children.

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Types of Visual SchedulesTypes of Visual Schedules

Object schedule

Photo schedule

Line drawing schedule

Written word schedule

Technology-based schedule (e.g. PDA)

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““Within” Activity SchedulesWithin” Activity Schedules

“Between” activity schedules take the child from place to place in the classroom (e.g. circle to snack)

“Within” activity schedules tell the child what to do once they get to the place

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Things to Think About when Things to Think About when Creating a ScheduleCreating a Schedule

What type of schedule should you use?

How is the schedule arranged (top-down v. left-right)?

How much information to include on schedule?

How to introduce flexibility into schedule?

Does everyone’s schedule look the same?

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Other Preventative VisualsOther Preventative Visuals

Use of Other “Helpful” Visuals

Hand prints

Foot prints

Wait (visual timer)

“Finished” or “All done” basket

http://images.google.com/imgres?imgurl=http://www.risingdove.com/jeffrey/handprints.gif&imgrefurl=http://www.risingdove.com/jeffrey/jeffrey.asp&h=286&w=480&sz=15&tbnid=DDSdZxxRz7FBsM:&tbnh=75&tbnw=126&hl=en&start=1&prev=/images%3Fq%3Dhandprints%26svnum%3D10%26hl%3Den%26lr%3D%26sa%3DN

http://images.google.com/imgres?imgurl=http://www.teachertools.org/documents/footprints-feet.jpg&imgrefurl=http://www.teachertools.org/bulletinboards_dynam.asp&h=825&w=638&sz=40&tbnid=Zs6KcQPOL53D7M:&tbnh=143&tbnw=110&hl=en&start=5&prev=/images%3Fq%3Dfootprints%26svnum%3D10%26hl%3Den%26lr%3D

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3. Appropriate Behavior Communicates

8/2/2007 Positive Beginnings Project 31

Challenging BehaviorChallenging BehaviorCommunicatesCommunicates

Children engage in challenging behavior because “it works” for them

Challenging behavior results in the child gaining access to something or someone (i.e., obtain/request) or avoiding something or someone (i.e., escape/protest)


Communication of Children with Communication of Children with AutismAutism

Children with autism need…

Means to communicate• PECS, language, written words, AAC

Motivation to communicate• Early, appropriate communicative attempts

should center around and result in access to powerful and natural reinforcers

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Putting Prevention into Putting Prevention into PracticePractice

Think of 1 child with or without autism in your classroom who exhibits problem behavior

Write down 1 prevention strategyArrangement of classroom environmentPredictability of classroom activities (routines &

rituals)Appropriate behavior communicates

Sharing Time

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Managing Problem Behavior Managing Problem Behavior PyramidPyramid

Respond

Replace

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Basic Behavioral PrinciplesBasic Behavioral Principles

Stimulus (S)/

Antecedent (A)

Response (R)/

Behavior (B)

Reinforcer (R)/

Consequence (C)

Transition time TantrumAllow child to stay in same activity

Behavioral History

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Basic Behavioral PrinciplesBasic Behavioral Principles

ReinforcerIncreases Behavior

PunisherDecreases Behavior

PresentFollowing occurrence of behavior

TangibleAttention

Positive

Aversive consequence

RemoveFollowing occurrence of behavior

Aversive condition (e.g. difficult task)

Negative


Basic Behavioral Principles Basic Behavioral Principles (cont’d)(cont’d)

Setting Event–event that occurs at another time in the child’s environment that increases the likelihood the child will engage in challenging behavior. Setting events serve to “set the child up” to have challenging behavior.


Some Potential Setting EventsSome Potential Setting Events

Change in MedicationsLack of SleepHungerArgument with ParentUnpredictable EnvironmentLittle Forewarning of TransitionsPresence of Certain PeopleOthers??

8/2/2007 Delaware PBS Project 39

Guiding Behavioral PrinciplesGuiding Behavioral Principles

1 Vast majority of appropriate and inappropriate behaviors are learned.

2 Problem behaviors are related to the context in which they occur.

3 Problem behaviors serve some function for the student.

4 Effective interventions are based on a thorough understanding of the student, the context, and the function of the problem behavior.

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What are the What are the Functions of Behavior?Functions of Behavior?

Individual’s engage in problem behavior for two basic purposes: To “obtain” something in their environment To “escape” something in their environmentWhat do we obtain? Tangible items (e.g., toys, access to remote control) Attention (e.g., from peers, parents, teachers) Internal sensory consequences--”it just feels good” (e.g.,

deep tissue massage, visual stimulation)What do we escape? Aversive situations (e.g., tasks, demands) Internal sensory consequences--”it doesn’t feel good”

(e.g., headaches)

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Let’s Play Guess that Let’s Play Guess that FunctionFunction


AmirAmir

Amir, a 3 year old with autism, has a temper tantrum when he sees another child in his class with a Sponge Bob toy. The teacher has to say “You can’t have that toy, it belongs to someone else.” Amir continues to cry and tantrum, becoming very disruptive. Typically, class peers say to the teacher “I’ll share my toy with Amir.” The teacher agrees. Amir takes the toy and immediately stops the tantrum.

____ ____ ____ ____ ____ ____ ____ ____8 letter word

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SharifSharif

Sharif is a kindergartner with high functioning autism. Sharif is very bright and knows the answers to many of the teacher’s questions but has difficulty waiting his turn, raising his hand, and speaking in a normal tone of voice. He is constantly talking out of turn in class. The teacher finds this very disruptive to her lessons. When Sharif blurts out the answer, often the teacher responds “That is right Sharif, but let someone else have a turn.” When the teacher says this, Sharif blurts out another answer.

____ ____ ____ ____ ____ ____ ____ ____ ____9 letter word

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HoyeonHoyeon

Hoyeon, a 6 year old girl who has autism, swings high & fast on the outdoor swing set incessantly during recess. Occasionally, children in the class approach Hoyeon on the playground, but she either pushes them away or doesn’t respond. Eventually, they stop approaching her. When the teacher suggests to the other children that they might play with Hoyeon, the children say that Hoyeon doesn’t want to play and continue to play with each other. Hoyeon continues to engage in this behavior daily taking no notice of the other children.

____ ____ ____ ____ ____ ____ ____ 7 letter word

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Replacing Problem BehaviorReplacing Problem Behavior

To replace problem behavior you want to make it

Irrelevant, Inefficient,

and Ineffective.

(O’Neill et al., 1997)


Replacing Problem Behavior Replacing Problem Behavior cont’dcont’d

Problem behaviors are irrelevant whenChild doesn’t need to escape anymoreChild has access to positive events more commonly

Problem behaviors are inefficient whenAlternative behavior is availableAlternative behavior is taught

Problem behaviors are ineffective whenProblem behavior NO LONGER works--it does not get the child what they want to obtain or what they want to avoid.

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Setting Events

Triggering Antecedents

Desired Alternative

Problem Behavior

Acceptable Behavior

Maintaining Consequence

Maintaining Consequence

Setting Event Manipulations

Antecedent Manipulations

Behavior Teaching

Consequence Modifications

INTERVENTION PATHWAY

SUPPORT PLANNING


Behavior Support Plan Behavior Support Plan Components:Components:

Prevention Strategies Modify setting events and antecedents (i.e.,

triggers) to reduce the likelihood that the problem behavior will occur and increase the likelihood that an appropriate alternative skill will be used.

Teaching Strategies Teach the appropriate alternative skill.

Consequence Strategies Maximize the use consequences to strengthen

the use of appropriate skills and reduce the occurrence of problem behaviors.


Design a Behavior Support Plan: Design a Behavior Support Plan: Preventative StrategiesPreventative Strategies

AKA: Make the problem behavior irrelevant

What modifications to the environment (academic, social, physical)

may PREVENT the problem behavior?

What adjustments will make the problem behavior unnecessary?


Examples ofExamples of Preventative Preventative StrategiesStrategies

Increase the effectiveness of instruction for this child(Direct Instruction, Small group or Individualized Instruction)

Increase academic skill levels(Ongoing assessment to ensure instructional match & success)

Modify the curriculum(Interests, preferences, choice, sequence)

Modify the demands (Quantity, difficulty, presentation, alternative tasks)

Clarify the expectations and make environment predictable(Use of schedule, charts w/ visual cues of steps)

Reorganize the physical & interaction setting(Use physical boundaries, pair or independent seats, change

seating of students)


Antecedent/Setting Event Antecedent/Setting Event StrategiesStrategies

Remove a problem event.

Modify a problem event.

Intersperse difficult or unpleasant events with easy or pleasant events.

Add events that promote desired behaviors.

Block or neutralize the impact of negative events.


Design a Behavior Support Design a Behavior Support Plan: Teaching StrategiesPlan: Teaching Strategies

AKA: Make the problem behavior inefficient

What skills can be taught to the student that:

1) will meet the same need, or function, as the problem behavior,

AND

2) will provide access to the desired outcome as “efficiently” as the problem behavior?

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Alternative Skills to be Alternative Skills to be TaughtTaught

Replacement Skills: One-to-one replacement skills that serve the exact function as the problem behavior.

General Skills: Broad skills that alter problem situations and prevent the need for problem behaviors.

Coping and Tolerance : Skills that teach students to cope with or tolerate difficult situations.

(Bambara & Knoster, 1998)


Replacement SkillsReplacement SkillsMatch Skills to FunctionMatch Skills to Function

Obtain: Attention, Activity, ObjectsProvide choices or preferencesFollow schedule & participate in routinesRequestInitiate interaction or gain attentionSelf-manage within activitiesWork toward delay of reinforcementUse first-then contingency systemOthers??


Replacement SkillsReplacement SkillsMatch Skills to FunctionMatch Skills to Function

Avoid / Escape: Activity, Attention, DemandsUse schedule or checklist to self-manageSet work goalsProvide preferences or choiceRequest and take breakParticipate in steps or portion of routineRequest or seek helpOthers??


Communication SkillsCommunication Skills

How to ask for or signal for:

help a breakinteraction attentiontime alone reduced demandsmore time alternative assignmentchoice opportunity to move aroundsensory input

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General SkillsGeneral Skills• Academic Skills• Use of Technology – hi and/or low tech • Organizational Skills • Independent Leisure or Play Skills• Vocational Skills

• Social Interaction Skills-Initiate and respond to interactions-Make friends-Participate in cooperative activities

(Janney & Snell, 2000)


Self-Management or Coping Self-Management or Coping SkillsSkills

Name & Recognize EmotionsUse of Emotion MeterDeep BreathingMuscle RelaxationPhysical Activity Stress Relief

Relaxation Techniques


Design a Behavior Support Design a Behavior Support Plan: Consequence Plan: Consequence

StrategiesStrategiesAKA: Make the problem behavior ineffective

What can I do to ensure that:

1) the problem behavior does not result in access to the desired outcome,

AND

2) the alternative behavior does result in access to the desired outcome?

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Important Questions to Think Important Questions to Think about in Assessment of Problem about in Assessment of Problem

BehaviorBehaviorSetting events & / or Antecedents Can I remove, neutralize, or modify ones for problem behavior

or put other ones in place that promote appropriate behavior (irrelevant)?

Behavior What replacement or alternative behavior should I teach that

will be as efficient (match to function, general skill, coping skill)?

Consequences What typically comes after the problem behavior now (what’s

the potential reinforcer)? What can I do to ensure that reinforcer no longer follows

problem behavior but rather appropriate behaviors (effective)?Episodes of Problem Behavior How can I respond differently?....Current strategy is not working


Name: Observer: Date:General Context: Time:Trigger (Setting Event and/or Antecedent):

Challenging Behavior:

Maintaining Consequence:

POSSIBLE FUNCTION:

Observation CardObservation Card


Activity/Routine MatrixActivity/Routine Matrix

Time/Activity Request HelpArrival √ CubbyPlanningCenters √ Toys;

computerClean-up √ SprayWashing HandsSnack √ MilkOutside Play √ Slide; toy

cabinetWashing HandsSmall Group √ Open

container

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Responding to Problem Responding to Problem BehaviorBehavior

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Managing Problem Behavior Managing Problem Behavior PyramidPyramid

Respond

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Consequence or Response Consequence or Response StrategiesStrategies

Don’t sweat the small stuff!!! Non-response or minimize response to

problem behaviorRedirect to use alternate skillReinforce use of alternative behavior

(immediately & consistently)Use natural or logical consequencesMaintain respect for student

(Janney & Snell, 2000)

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Monitoring ProgressMonitoring Progress


Evaluating a Behavior Support Evaluating a Behavior Support PlanPlan

Measuring Progress - What Information to Collect:Increases in use of alternative skills

Reductions in occurrence of problem behavior

Positive side effects (e.g. improved grades, increased attention, peer acceptance)

Improvements in consumer satisfaction (e.g., student, family, staff, and others)


Evaluating a Behavior Support Evaluating a Behavior Support PlanPlan

Measuring Progress - How to Collect InformationInterviews (e.g., teachers, students, parents,

service providers)

Informal and anecdotal reports (e.g., communication logs with parents, teacher progress notes)

Rating scales (e.g., student effect, social scales, opportunity for choice)

Natural documents (e.g., report cards, incident reports, medical records, placement records)

Direct observation (e.g., frequency counts, measures of duration, observation logs)

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Re-CapRe-Cap

Context


Characteristics of Autism

Respond

Replace

Prevent

Re-Thinking Problem Behavior Managing Problem Behavior

8/2/2007 70

Re-cap Re-cap

IrrelevantAntecedents

InefficientAlternative skill

IneffectiveAccess to reinforcer



3. Appropriate Behavior

Communicates

Preventing Problem Behavior Replacing Problem Behavior

8/2/2007 71

Presenter Contact InfoPresenter Contact Info

E-mail Address: [email protected]

mailto:[email protected]

managing the behavior of children with autism in inclusive classrooms

Documents

thinking problem behavior

types of problem behavior

problem behavior1

classroom arrangement

classroom setup

behavior of children

appropriate supports

sensorybased toys