Documentos de Académico
Documentos de Profesional
Documentos de Cultura
editor-in-chief
scientific
advisory board
Jack M. Gorman, MD
F a c i l i t a t o r G u i d e
2008
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Oxford Universitys objective of excellence
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iv
About ProgramsThatWork
Stunning developments in health care have taken place over the last
several years, but many of our widely accepted interventions and strate-
gies in mental health and behavioral medicine have been brought into
question by research evidence as not only lacking benet but perhaps
inducing harm. Other strategies have been proven eective using the best
current standards of evidence, resulting in broad-based recommendations
to make these practices more available to the public. Several recent devel-
opments are behind this revolution. First, we have arrived at a much
deeper understanding of pathology, both psychological and physical,
which has led to the development of new, more precisely targeted inter-
ventions. Second, our increased understanding of developmental issues
allows a ner matching of interventions to developmental levels. Third,
our research methodologies have improved substantially, such that we
have reduced threats to internal and external validity, making the out-
comes more directly applicable to clinical situations. Fourth, governments
around the world, health care systems, and policymakers have decided
that the quality of care should improve, that it should be evidence-based,
and that it is in the publics interest to ensure that this happens (Barlow,
2004; Institute of Medicine, 2001).
v
The manuals and workbooks in this series contain step-by-step, detailed
procedures for assessing and treating specic problems and diagnoses. But
this series also goes beyond the books and manuals by providing ancillary
materials that will approximate the supervisory process in assisting prac-
titioners in the implementation of these procedures in their practice.
vi
References
vii
Acknowledgments
A number of professionals guided and directed this work over the years
and we are deeply indebted to them. We would especially like to thank
Carolyn Kesslerwhose dissertation served as the pilot project for this
approachand the therapists who field-tested this protocol (Melissa
Zona, Shelley Clark, Laura Casper, and Kristin Knapp-Ines), as well as
Bobbie Vaughn who contributed to the early development of the proto-
col. We would also like to express our gratitude to the many parents who
have taken part in our research and taught us so much. Support and
funding from the University of South Florida St. Petersburg and the
U.S. Department of Education Office of Special Education Programs
assisted greatly with this work. The developmental editor for this book
Julia TerMaathelped wrestle and make sense of a tremendous amount
of information that went into these plans and we truly appreciate her
patience and guidance.
viii
Contents
References 125
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Chapter 1 Introductory Information for Facilitators
1
parents how to better approach their child, with the goal of helping
them persist with treatment until they experience success with the
intervention.
2
problem behaviors can pose a physical threat to children and those who
work with them.
3
packages that combine the most eective strategies (Dunlap et al., 2000;
Horner et al., 1990; Koegel, Koegel, & Dunlap, 1996; Sugai et al., 2000).
PBS has a set of key features that will be introduced in Session 1 and
elaborated throughout this protocol. In this introductory section, we
provide a brief summary of those features with references to relevant lit-
erature to assist facilitators wishing to expand their knowledge. First,
PBS involves the identication of consequences maintaining problem
behavior and other associated environmental factors (Day, Horner, &
ONeill, 1994; Durand & Crimmins, 1988; Iwata, Dorsey, & Slifer,
1994; ONeill et al., 1997). Using a process of functional assessment,
the purposes a behavior is serving for the child may be gleaned
(e.g., gaining attention, avoiding diicult tasks). With this information,
more eective strategies can be identied that allow children to adapt
to environments and meet their needs in more productive ways (Carr
et al., 1999). Methods for collecting data and completing functional
assessment are presented in Sessions 1 through 3.
4
(e.g., waiting), andpossibly most importantcommunication.
Management involves controlling access to reinforcers (e.g., attention,
escape) so that they are available for only positive (not problem)
behavior. A foundation of PBS that combines its components and is
well documented in the research literature is functional communication
training (FCT). Because of its importance and level of empirical sup-
port, we will describe it in greater detail in the following section.
5
result, PBS has become the foundation of many intervention and par-
ent support practices (Hieneman, Childs, & Sergay, 2006; Lucyshyn,
Dunlap, & Albin, 2002); however, actual implementation of positive
behavior support with families in integrated, real-life situations is com-
plicated and requires attention to a variety of factors to be successful.
6
They found that both interventions initially reduced problem
behaviors but that the participants demonstrated a preference for
FCT. This advantagepreference by consumersis an important
aspect of clinical utility.
Limitations
Although evidence exists that PBS and, more specically, FCT can be
eective, there may be limits to its impact in community settings. These
limitations may be related to the acceptability of the treatments and/or
the degree to which the interventions are appropriate to the settings and
circumstances (Albin et al., 1996; Kazdin, 1981; Reimers, Wacker, &
Koeppl, 1987). Failure to design plans appropriately or provide suicient
support and guidance to follow through can impede generalization and
maintenance.
7
The applicability of these interventions to the broader population,
referred to as clinical utility, is of particular concern (Durand & Rost,
2005). Are our treatments eective with all families who have children
with severe behavior problems, or are there subgroups with whom we
are more or less successful? For example, how many families give
up on eorts to assist their children (Munro, 2007)? Our clinical
experience and research from other areas of study outside of the dis-
abilities eld suggest that up to 50% of families refuse participation in
parent training for a variety of reasons (e.g., Irvine et al., 1999). For
example, between 40% and 60% of families who begin treatment
related to child mental health issues terminate services prematurely
(Kazdin, 1996). It is unclear, however, how many families of children
with more severe cognitive and developmental disorders who begin
behavioral parent training drop out or otherwise do not complete
intervention.
8
included measures of IQ, DSM-IV diagnosis, child behavior problems,
child adaptive skills (communication and social skills), and a variety of
family indicators (e.g., stress, attitudes, etc.).
9
them feel more optimistic about their abilities to work with their chil-
dren? In turn, if we can successfully intervene with these families to
assist them with this attitudinal barrier, will it help them continue
in and complete behavioral parent training, and will this lead to
improvements in child behavior? The answers to these questions have
been tested in a study of children with behavior problems and their
families.
10
behavioral therapy approach suggests that signicant improvements can
be observed in persons with pessimistic styles, which, in turn, results in
improvements in such areas as depression.
Background of Facilitators
11
Outline of This Treatment Program
By the end of the program, parents will have worked through all ve
steps of positive behavior support: Step 1) Establish goals, Step 2) Gather
information, Step 3) Analyze patterns, Step 4) Develop a plan, and
Step 5) Monitor results. Throughout the sessions, parents engage in cog-
nitive-behavioral therapy to increase their optimism about their childs
behavior and their ability to follow through with the intervention.
In each session, the facilitator reviews the previous session and asks par-
ents if they have any questions regarding the content from the previous
Session #1 Introduction and Goal Setting Identify situations and associated self-talk
Session #2 Gathering Information Determine the consequences of beliefs on
behavior
Session #3 Analysis and Plan Design Use a distraction to interrupt negative
thinking
Session #4 Preventing Problems Dispute current thinking (accuracy and
impact)
Session #5 Managing Consequences Substitute with more positive, productive
thoughts
Session #6 Replacing Behavior Practice skills developed for recognizing and
modifying pessimistic self-talk
Session #7 Putting the Behavior Support Continue practicing skills developed for
Plan in Place recognizing and modifying pessimistic
self-talk
Session #8 Monitoring Results and Wrap-Up Help identify strategies to maintain positive
changes in self-talk
12
week. The facilitator then goes over the parents Weekly Progress Report
and homework to determine what has been accomplished. If parents
have not completed all of the homework, the facilitator assists them in
doing so. Throughout this review, the facilitator provides feedback and
guides parents to consider other ideas as necessary.
After outlining the goals of the session and presenting the content,
facilitators provide examples as needed and help parents to apply the
ideas to their own children, families, and circumstances. Facilitators
should encourage parents to write down the ideas they generate on the
homework forms in the workbook. Facilitators should also document
the relevant information shared by the participants in the notes sec-
tion of the delity checklists; these notes can then be used to facilitate
the Application sections that follow and provide a starting point for
future discussions. At the end of each session, facilitators go over the
homework instructions and forms, making sure parents are prepared
to complete them.
13
among those involved in the childs care is essential to the success of
the behavior plan. Troubleshooting with families and their teams might
be necessary if one or more members have diiculty collaborating
eectively.
Participants will vary in their background and ability to grasp the con-
cepts presented. Therefore, facilitators should pace material and adjust
their language based the needs of the participants. The examples used
should be relevant to the child and the family. It might be necessary for
facilitators periodically to shift between topics based on the participants
needs.
As parents must act as the primary therapist with their child, use of the
workbook helps ensure their active participation. Encourage parents to
attend all the sessions and complete the homework. If parents are having
any trouble understanding, give additional examples or spend more time
as needed. Stress to parents that their persistence is crucial to successful
intervention of their childs behavior problems. As children with
signicant challenging behaviors often continue to need support, the
workbook is a valuable resource for parents to refer to after therapy has
ended.
14
Chapter 2 Identication and Assessment of Challenging
Behavior
Interviews
15
and an alternative approach that starts with gathering a complete
developmental history and progresses to the current concern. A clear
advantage of conducting interviews is the ability to gather a signicant
amount of information in a short period of time (Rush, Bowman,
Eidman, Toole, & Mortenson, 2004).
16
Rating scales typically have better psychometric properties than inter-
views and can recognize low-frequency behaviors. On the other hand,
rating scales rely on recollections, which are subjective in nature and
subject to bias (Rush et al., 2004).
Functional Assessment
17
behaviors are related to behavioral function (e.g., escape from the
demands of others or seek attention from others), a comprehensive
assessment of maladaptive behavior should include a functional assess-
ment of behavior. A variety of techniques assist clinicians, educators,
and families in determining the role of antecedent and consequent
inuences on behavior. This information is essential for proper treat-
ment design.
18
the circumstances surrounding the behavior (e.g., the Functional Analysis
Observation Form, ONeill et al., 1990). A scatter plot is a practical
tool for assessing low-frequency behaviors or behaviors that occur in
bursts, and it assists with identifying patterns of responding (Touchette,
MacDonald, & Langer, 1985). Scatter plots allow examination of the fre-
quency of behavioral occurrences across activities or times of day and are
also useful for recognizing changes in behavior patterns.
The one rating scale with the most research support is the Motivation
Assessment Scale (MAS): a questionnaire that is administered to teach-
ers, paraprofessionals, family members, or anyone else who has a great
deal of contact with the child (Durand & Crimmins, 1988, 1992). The
MAS asks questions that determine where, when, and under what con-
ditions problem behaviors occur and determines their motivations. It is
available free online at http://www.monacoassociates.com/mas/
MAS.html. Information from the MAS, along with other forms of
functional behavioral assessments, is used to design plans for reducing
the behavior problems.
More research is needed for the tools described in this section in order
to demonstrate and improve their psychometric properties (e.g., relia-
bility and validity). In the meantime, however, they are the most useful
resources for assessing the nature and severity of problem behavior and
conducting functional assessments.
19
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Chapter 3 Session 1: Introduction and Goal Setting
Materials Needed
Outline
21
Help parent establish goals
Assign homework
Introduction to Training
Explain the purpose of the sessions and what to expect over the course
of the training. Answer any questions as needed. You may want to use
the following dialogue:
Remind the parent that anything he shares with you will be condential;
you will not repeat it to other people or use it in any way unless he gives
you permission. Let the parent know that you may take notes during the
session; the notes are simply to help you remember important things the
parent says so that you can discuss them later as needed.
Preview the overall agenda for the training sessions and the topics to be
addressed within this rst session. Refer to the parent workbook,
explaining how it will be used for homework and self-study.
Tell the parent that the sessions will include discussions regarding his
thoughts and feelings and explain why this is important. The following
dialogue may be helpful:
22
In addition to teaching you how to develop a plan for your child, we
will be asking you to share your thoughts and feelings about your
childs behavior. We do this for a couple of reasons. First, to help you
create a good plan for your child and family, we need to get to know
you and what is important to you. Second, we realize that our
thoughts can aect our feelings and behavior. Exploring your
perceptions as we go through the process may help you to be more
successful and better able to overcome any challenges you face.
Inform the parent that the way in which you will approach this is by
discussing what he thinks and feels during each of the sessions, as well
as having him record his thoughts and feelings between sessions.
Introduce the Self-Talk Journal (refer to the parent workbook). Provide
an opportunity for the parent to ask any questions.
Explain that during this session you will focus on identifying what the
parent thinks and feels when things are going well and when things are
particularly challenging. You will help the parent determine what situ-
ations prompt positive and negative self-talk.
Application
Have the parent list areas of diculty and success his child has. Give
him a choice of starting with the childs successes or diculties, and ask
him to pick a specic situation and to talk about what he thinks or feels
when it occurs. Record or have the parent record responses in the rst
two columns of the Self-Talk Journal. Do the same for the other area
(diculty or success).
Throughout the session, help the parent to recognize his thoughts and feel-
ings as well as the circumstances that precipitate them. This may be done
while he is relating his experiences by asking questions such as: What
were you thinking when that happened? Exactly what was going on that
made you feel that way? If the parent provides a vague reply (e.g., I was
thinking, oh no, here we go again ), ask him to explain what that means
to him. Keep asking questions (e.g., What do you mean? What do you
think is going to happen?) until the thoughts are explicit. Pay attention
to the parents body language as you discuss dierent topics. If the parent
23
appears to be uncomfortable or resistant, prompt him to identify his self-
talk by saying something like You seem uncomfortable. What are you
thinking right now? These questions should be blended throughout the
session and not unnecessarily interrupt the ow of the training.
Explain that the approach used in this program is based on the princi-
ples of applied behavior analysis and, in particular, positive behavior
support (PBS). Briey describe its background. (The following sections
involve a great deal of lecture. It may be benecial to warn the parent
and explain that this will not be the norm throughout the training.) You
may want to use the following dialogue:
Explain that, in the past, approaches were often trial and error eorts
that were reactive and focused on decreasing behavior. PBS oers a
practical, problem-solving approach that emphasizes important values
such as treating children with disabilities in ways similar to their non-
disabled peers. PBS helps us understand what causes childrens behavior
so we can select the right strategies to improve it.
Next, describe and provide examples of the key features of the program
(i.e., positive behavior support) as outlined here.
24
Assessment
At the heart of PBS is the assumption that we need to know why a child
is misbehaving in order to design a successful plan. We can nd out why
children act out by looking at the situations that seem to set the stage
or provoke behavior problems and what the child may be gaining or
avoiding by misbehaving. By understanding why problem behaviors
occur (i.e., their purpose) and the situations that seem to set o these
behaviors, we are then able to develop eective solutions.
A great deal of research stands behind the PBS process as a way of gain-
ing an objective understanding of a childs behavior. There are several
methods we can use to try to nd out why a child is misbehaving as part
of a process called functional behavioral assessment (FBA). This can
involve structured observations by educators and other professionals
and the use of questionnaires; however, the process can often be imple-
mented less formally by parents and other care providers to successfully
understand a childs behavior. Part of the next few sessions will be
devoted to helping the parent understand his childs behavior using
dierent forms of FBA. Tell the parent that, just like detectives, we will
look for clues to understand his childs behavior better. Through this
process we will gure out when, where, with whom, and why the child
behaves in certain ways.
25
(If appropriate, ask the parent if something like this has ever happened
to him and to consider how he would think or feel in this circumstance.)
Explain that our understanding of the possible purposes of behavior or
circumstances aecting behavior provides the basis for how we address
behavior. Knowing the patterns allows us to adjust particular circum-
stances and outcomes surrounding behavior. As we come to better
understand a child and his motivations, we are empowered to deal with
his behavior in a more positive and eective manner.
Prevention
Teaching
26
Management
Changing Lives
Collaboration
27
a variety of people who are important in the childs life are essential.
Cooperation and involvement are encouraged, therefore, not just from
both of the parents but also from other family members, teachers, ther-
apists, friends, and anyone else who could have an impact on what hap-
pens with a childs behavior. This type of working relationship requires
that everyone communicate openly with one another and develop plans
that make sense everywhere problems occur. Having shared goals and
responsibilities provides buy-in by everyone and helps improve the
likelihood of successful outcomes. This collaboration is essential for
understanding a childs behavior, putting strategies in place, and mak-
ing sure they work.
Introduce the case study of Ben, explaining that the case will be used to
illustrate each of the ve main steps of the PBS process and be inter-
woven throughout the remainder of the sessions. (If Bens case study
would not be relevant to the participating parent, substitute another
example that includes all of the elements described in the case example
sections throughout the book). The initial description should include
the childs age, sex, strengths, challenges (and the impact of those chal-
lenges on the child and family), and family circumstances.
Ben is 3 years old. He is an only child and lives with both of his
parents. His father works as a data programmer, and his mother
stays at home with him. Bens grandmother lives nearby and visits the
family almost daily. Ben attends a preschool program for children
with developmental delays and disabilities from 9:00 to 12:00 on
weekdays.
Ben loves to play alone, has a keen interest in animals, and is especially
good at working puzzles. Ben has very limited spoken language, using
only a few words and more often relying on sounds, gestures, and prob-
lem behaviors to get his needs met. Ben has extreme diculty with
changes in activities, routines, or settings. He often refuses attempts by
his parents or other children to play with him. When others interrupt
28
his play or change his activity or routine, Ben cries, screams, and drops
to the oor. When he is required to go somewhere in the car, he resists
getting his shoes on and being taken to the car, and then he continues to
cry well into the trip. Ben eats very little at breakfast or lunch and is
usually extremely hungry by dinnertime. He then cries and screams
until his mother gives him something he wants to eat. He eats his food
while wandering around the house. Ben resists tooth brushing and is not
potty trained. His parents reluctantly admit that he still sleeps with
them every night.
The challenges posed by Bens disability and problem behavior leave his
parents very isolated and discouraged. They feel that they cannot go
places or spend time with family and friends. Other than school, they
try not to take Ben out. In fact, they take turns running errands,
leaving one parent to stay at home with Ben. They cannot leave Ben
with babysitters because they feel that nobody else can handle him. Bens
mother believes her husband is denying his disability and is frustrated
with her mother-in-laws frequent comments that Ben just needs proper
discipline. All of these things are creating tremendous stress on the
marriage and family.
29
Step 4) Developing a plan: creating strategies to prevent prob-
lems, teaching the child better ways of behaving, and responding
appropriately to behaviors when they occur
PBS is most eective when everyone who cares for and interacts with
a child is involved. This is because, working together, we can be
condent that everyone in the childs life agrees on the goals, shares
ideas and information openly, understands the patterns associated
with the childs behavior, and is committed to following through with
the plan. The PBS process works because everyone is learning together
and supporting one another.
The people who should be involved in the process include parents, fam-
ily members, teachers, friends, and others who interact with the child.
At minimum, this includes those who know the child best, see the
child on a daily basis, and will ultimately be using the plan. To work
together eectively, everyone must agree to participate, communicate
openly and respectfully, and resolve problems together as they arise.
To make the PBS process work, both of Bens parents, his grandmother,
and preschool teacher needed to be included. This meant having family meet-
ings and communicating with his teacher through email and conferences.
Application
Ask the parent to consider briey who should be involved in the PBS
process and how to engage them. (If the parent discusses or alludes to
30
any discrepancies in perspectives or practices [e.g., with an estranged
spouse] explore his thoughts or feelings.)
Establishing Goals
Explain the rationale for setting broad goals for childrens behaviors and
lives and provide examples of such goals. The following dialogue may
be used:
The rst step in the positive behavior support process is to create a clear,
positive vision for the future. Before trying to understand and address a
childs problem behavior, it is important to consider what broad goals
we want to achieve through our eorts. We may want to consider why
changing a childs behavior is so important and what we would ulti-
mately like to see in terms of changes in the childs life. Through this
process, we want to achieve more than just changing or stopping certain
behaviors; we want your child and your family to have better lives.
Having a positive vision for the childs future gives the parent and other
family members hope and direction. Identifying these goals also builds
unity among those involved in the life of the child. The result is greater
optimism and motivation to make the changes needed, as well as better
outcomes for the future.
31
Case Example: Bens Goals
Bens family developed the following goals: help him play with other
children and adults, better handle transitions and change, and ride in the
car and eat with the family without problem behavior. In addition, his
parents wanted him to develop more interests (beyond animals and
puzzles) and participate in typical childhood experiences, including
spending time with friends. They also wanted him to become more inde-
pendent with his self-care, to sleep alone, and to develop the skills he
needed to keep himself safe (e.g., looking out for trac). Bens parents
wanted to be able to enjoy life as a family without the constant stress pre-
sented by his problem behavior. They hoped to be able to go places and do
more things as a family and to reduce the conict in their lives.
Application
Taking into account the information presented in this section, have the
parent consider his childs strengths and challenges and identify at least
one goal he has for his child. (If discussion of the future prompts strong
feelings, explore the parents self-talk by saying something like, When
you think about the future, what comes to mind?) The goals should be
broad but objective, and they should include things such as increased
independence, community participation, and friendships. The goals
should be recorded on the Establishing Goals form in the workbook.
32
Make sure that everyone interacting with a child is addressing the
same concerns and is on the same page
Use other examples as necessary and appropriate. Make sure the behav-
iors are objectively stated (in terms of what the child says or does).
33
Application
Have the parent dene one or more of his childs behaviors of concern
and record his denition(s) on the Dening My Childs Behaviors of
Concern form. ( You may also want to again discuss, if appropriate, the
parents ability to be objective regarding his childs behavior.) If the par-
ent identies multiple behaviors, help him to prioritize those behaviors
(e.g., the top three).
34
Behaviors, Timing Behaviors, Rating Behaviors, and Frequency Graph.
See Figures 3.1. through 3.4 for example rows from each form (based on
the denition of Bens tantrums). Point out the pros and cons of each
instrument so the parent can select one that will work at home.
Figure 3.1
Completed Example Row of Counting Behaviors Form
Figure 3.2
Completed Example Row of Timing Behaviors Form
Figure 3.3
Completed Example Row of Rating Behaviors Form
10/13 10/14
10 10
9 9
8 8
7 7
6 6
5 5
4 4
3 3
2 2
1 1
Figure 3.4
Completed Example Rows of Frequency Graph Form
35
Application
Homework
36
Have parent complete the Dening Behavior form.
Have parent complete the Establishing Goals form.
Have parent complete selected data collection forms (e.g., Counting
Behaviors, Timing Behaviors, Rating Behaviors, Frequency Graph).
37
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Chapter 4 Session 2: Gathering Information
Materials Needed
Interview Form
Scatterplot form
Behavior Log
Outline
Preview agenda
Review homework
39
Review recording information
Assign homework
Agenda Preview
Preview the agenda for this session as referred to in the outline. Add any
other items relevant to the parent.
Homework Review
Ask the parent if she has any questions about the previous session or the
workbook reading. Review homework forms for denition of behavior,
broad goals, and baseline data. (If the parent did not complete the
homework, help her to identify goals and problem behaviors, suggest-
ing that she review them with the other members of her team between
sessions.)
Review the Self-Talk Journal and ask the parent to choose one success
and one diculty from the past week and read the entry (including the
situation and self-talk) aloud. If the parent is not comfortable reading
her journal, she may paraphrase it or let you read it. Note any pessimistic
thoughts. Ask the parent what the consequences were for the pessimistic
beliefs (e.g., So Jimmy was having a tantrum at the library, and you
were thinking, Im a bad Mom; I cant take him anywhere. What hap-
pened next? How did you respond to the tantrum?). Also note how the
parent describes her successes: whether she takes credit for good events
or attributes them to something else (e.g., good health, fewer demands).
40
Relationship Between Thoughts and Behavior
Application
Have the parent select one of the negative beliefs she shared previ-
ously and identify the consequences of that belief (including how she
reacted to the situation). Have her record it in the Self-Talk Journal
as an example.
Throughout the session, help the parent to recognize her thoughts and
feelings, the circumstances that precipitate them, and the consequences
of those beliefs. This may be done while she is relating her experiences
by asking questions such as:
41
Understanding Behavior
You serve as the eyes and ears of this important next step, allowing us
to get an insiders view of what goes on during a typical day and
night with your child. We need to begin to understand what things
seem to trigger behavior problems and why they might continue to
occur despite your best eorts. We will work together using some
simple tools: focusing on what is going on before your child misbe-
haves and what happens right after these incidents. This important
information will allow us to design ways to interact with your child
and will also help us to identify specic skills to teach your child that
will signicantly improve behavior.
Antecedents
When does it occur? (e.g, in the morning, at dinner, after play dates)
42
In addition to the immediate inuences on behavior problems, other
events or conditions can aect how a child will behave. These conditions
do not by themselves seem to trigger behavior problems, but they will
make these behaviors more likely to occur when the triggers are present.
Examples of more distant events or circumstances (sometimes called set-
ting events or establishing operations) that can inuence behavior are:
Consequences
(If appropriate, discuss how thoughts and feelings can serve as a mediator
to our reactions; for example, when we interpret a childs behavioror
the impact of her behaviorin a particular way, it may aect how
we react.)
43
or goal, of a childs problem behavior. By completing it, we can make
an educated guess regarding whether behavior is motivated by atten-
tion, tangibles, sensory outcomes, or escape.
Application
Observing Behavior
44
frequently when the child is approached in a certain way or that
the child is able to avoid completing at least part of an activity she
dislikes through her behavior). Use the following dialogue in your
discussion:
Bens parents decided to pay attention to times when Ben could change
activities without problems (e.g., when he was going to do something he
really liked) and compare them with times that were dicult. They also
wanted to look at playtime to try to gure out how involved they could get
in Bens play and how much they could do with him (e.g., sitting near
him, handing him toys) before he would resist. They thought that by look-
ing closely at those circumstances they could get a better idea of what was
inuencing his behavior.
Interviewing People
45
include. Provide examples of questions (see Interview Form in the
workbook). Use the following dialogue to begin:
(If the parent discusses dierences in how people perceive her childs
behavior, prompt her to discuss those perceptions and how they con-
trast with her own.)
Tell the parent that, during the interviewing process, the following
should be explored:
Suggest that it may be helpful for the parent to record what she learns
through these discussions, as sometimes it is easier to nd a pattern
when the information is down on paper. Explain that there are a vari-
ety of ways that can be used to record the responses (including the
Interview Form in the workbook).
Bens parents decided to make individual lists of the times that things
were easy and hard for each of the parents with Ben. They could then
compare notes and discuss what was happening more objectively, looking
at the when, what, and where of their challenges with Ben. They decided
to ask the same of Bens teacher and grandmother.
46
Recording Information
Scatterplot
Behavior Logs
47
ScatterPlot
Child: _________Ben_____________
___ Behavior: ______________________________________
Screaming, crying, and dropping to the floor
Dates: _____
5/1___ through ______
5/10___
__
Record the times of day (and/or activities) in which the behavior might occur. Write in the dates for the
recording period in the rst row. When the behavior occurs, shade in the corresponding box.
Dates
Time Activity 5/1 5/2 5/3 5/4 5/5 5/6 5/7 5/8 5/9 5/10
78 Preparing for school
a.m.
89 Transition to school
a.m.
910 Arrival/centers
a.m.
1011 Outside
a.m. (transition)
1112 Swim/change
p.m.
121 Lunch
p.m.
12 Transition home
p.m.
23 Arrival home /
p.m. change
34 Home/play alone
p.m.
56 Dinner
p.m.
67 Bath
p.m.
78 Bedtime
p.m.
Figure 4.1
Example of Completed Scatterplot
Source: Adapted from Touchette, MacDonald, & Langer, 1985.
48
Behavior Log
Record situations in which your childs behavior is dicult, including specically what your child says
and does and what occurs before and after the behavior.
Antecedent Consequence
(Before Behavior) Behavior (After Behavior)
Bens mother asks him to put on Ben extends his body, Bens mother takes his shoes to
his shoes cries, and screams the car, letting him go in his
bare feet
Bens mother guides him from Ben cries and screams Classroom assistant hands him
the car into school a toy and brings him into the
class
Ben is told it is time to come Ben extends his body, Assistant waits for him to get
inside from the playground cries, screams, and then calm and then physically guides
drops to the ground him in
Bens mother sits down to play Ben extends his body, Bens mother says I just want
with him cries, and screams to play with you and then moves
away, leaving him alone
As dinner time nears, Bens Ben walks into the Bens mother quickly gives him
mother goes into the kitchen kitchen and begins to cry one of his favorite foods
and then scream
Bens father asks him to sit at Ben sits brieffy and then Bens mother asks him to come
the table to eat picks up his food and walks back or says dont you want to
around sit? and then lets him go
Figure 4.2
Example of Completed Behavior Log for Ben
49
Provide examples of completed ABC recordings, and practice com-
pleting the Behavior Log form with the parent as needed to rein-
force this concept. Refer to the case example of a behavior log in
Figure 4.2.
Choosing a Strategy
Application
Prompt the parent to look over all of the tools for interviewing other
people and recording information presented in this session, discussing
the pros and cons of each. Help her select and plan strategies for gath-
ering information. Have her record ideas on the form provided in the
workbook (see Information Gathering Plan). Guide her to be realistic
about what she can do, even if it simply involves paying attention to a
particular situation and talking to a couple of people.
Homework
50
Have parent develop a plan for gathering information about the
childs behavior (e.g., using the Interview Form, Scatterplot, Behavior
Log, or some other format if appropriate).
Encourage parent to talk with family members and others to get their
input.
51
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Chapter 5 Session 3: Analysis and Plan Design
Materials Needed
Outline
Preview agenda
Review homework
Assign homework
Agenda Preview
Preview the agenda for this session as referred to in the outline. Add any
other items relevant to the parent.
53
Homework Review
Ask the parent if he has any questions about the previous session or the
workbook readings.
Review the Self-Talk Journal and ask the parent to choose one success
and one diculty from the past week and share the entry (including the
situation, his self-talk, and the consequences of his self-talk). When the
parent has shared his entries, review how his thoughts and feelings
inuenced his behavior in each situation. For example, you might say
something like:
It sounds like you believe you are a bad father because you cant
control Mary during public outings, so you just avoid taking
her out at all. In the example you shared, your belief about
your parenting skills aected your decision to stay home rather
than take an opportunity to teach Mary how to behave in
public.
Point out any positive events the parent fails to take credit for, and
where credit is probably due (e.g., You had a couple of very success-
ful outings as a family; you must have done a lot to contribute to those
successes).
54
Use of Distraction
Singing to oneself
Writing down the belief and throwing the piece of paper away
Application
Have the parent decide what distraction strategies he will use and in
what situations they might be helpful. Have him make a note of the
strategies he plans to use under the comments section of his Self-Talk
Journal. Throughout the session, help the parent to recognize his
thoughts and feelings, the circumstances that precipitate them, and the
consequences of his beliefs. Remind him to use distraction (e.g., You
are stating some negative ideas, how can you stop them?) when neces-
sary to interrupt unproductive thinking.
Pay attention to the parents body language as you discuss dierent topics.
If the parent appears to be uncomfortable or resistant, prompt him to iden-
tify his self-talk by saying something like, You seem uncomfortable. What
are you thinking right now? This discussion should be blended through-
out the session and not unnecessarily interrupt the ow of the training.
55
Analyzing Patterns
Stress that what we are looking for are patterns that repeat themselves
typical sequences that occur in dierent situations and on dierent
days. The goal is to identify situations that occur again and again, allow-
ing us to predict circumstances in which we are likely to see behavior
problems. In other words, we determine what situations are expected to
set the stage for behavior and what consequences, outcomes, or results
reliably follow the behavior. If we already have assumptions about what
is aecting a childs behavior (which is often the case), the purpose of
this step is to use the information we collect to either support or chal-
lenge those assumptions.
What are the circumstances (i.e., when, where, with whom, dur-
ing what activities) in which the behavior is most likely and least
likely to happen?
What would cause the child to behave this way, and what would
make the child stop?
56
(If the parent oers an explanation such as she just cant help it for
the childs behavior, prompt him to consider the impact of that kind
of self-talk on his expectations of his child or on his reactions to the
behavior.)
Explain that behaviors can serve more than one function for a child.
Use the following dialogue:
Results: mother leaves him alone, feeds him quickly, and lets him walk
around with food; limits trips in the car; and generally delays transitions
Broader Issues
57
distant events that are inuencing the childs current behavior. These
might include:
58
served by the behavior. Setting events might also be identied. The
statement should be specic, concise, and broadly applicable.
When Bens parents try to put his shoes on to leave the house, he screams,
cries, and drops to the oor. This delays the transition, forces his mother to
take him out without shoes, or results in her canceling the errand or getting
someone else to do it.
When his parents or peers try to play with Ben, he screams and cries; if
they dont back o, he turns his back on them or pushes them away.
Eventually, the children or family members back o, and Ben is able to
continue playing contentedly by himself.
When Ben doesnt eat well at breakfast and lunch, he screams and cries
as dinnertime approaches. If Mom doesnt feed him right away, he gets
louder and runs around the kitchen. As a result, she quickly prepares
him something he likes to eat. She often allows Ben to carry his food
around (rather than requiring him to sit with the family during meals).
Testing Hypotheses
59
Application
Have the parent look at all of the information collected so far and look
for patterns for each behavior category. Using the Pattern Analysis
Worksheet or a ip chart, ask the parent to consider the circumstances
(when, where, with whom, what activities) and consequences (what the
child gets or avoids as a result) of the behavior. If the patterns are not
clear, continue to probe (e.g., Does that happen every time? If not,
why?). If there is time, repeat this process for other behavior patterns.
60
Identifying Strategies
The three general strategies that make up a behavior support plan are:
(If appropriate, guide the parent to recognize that changing his own
behavior might also involve changing his self-talk or his beliefs about
his childs behavior.)
61
Present an example of a hypothesis (see summary statements for Ben in
earlier case example), and ask the parent to identify one or more strate-
gies to prevent problems, manage consequences, or replace behavior.
Share other examples as appropriate and necessary.
Application
Homework
62
Chapter 6 Session 4: Preventing Problems
Materials Needed
Outline
Preview agenda
Review homework
Assign homework
63
Agenda Preview
Homework Review
Ask the parent if she has any questions about the previous session or
workbook readings. Review homework: summary statements, strategies
based on hypotheses, and data collected. (If the parent was unable to
generate usable hypotheses, work with her to create or revise them.)
Review parents Self-Talk Journal. Ask the parent to choose one success
and one diculty from the past week and share the entry (including the
situation, self-talk, and the consequences of the self-talk). Have the par-
ent describe how she used distraction when faced with pessimistic
beliefs and discuss how eective that strategy was in stopping the esca-
lation of those thoughts.
Disputation Process
Step 1: Identify the negative belief (i.e., What exactly do you say
to yourself that is pessimistic?). For example, a parent might say
something like, Nothing I do makes a dierence with my childs
behavior.
64
require her to restrain her child anymore. Therefore, her actions
are making a dierence. When she ignores her childs screaming,
it initially gets louder and more dramatic but then it stops.
Application
Have the parent consider one of the negative beliefs she just shared
from her Self-Talk Journal. Guide her through the four steps to dispute
that belief. Help her record the information as an example in column 4
of her Self-Talk Journal.
Throughout the session, help the parent to recognize her thoughts and
feelings, the circumstances that precipitate them, and the consequences
of those beliefs. Make sure she is explicit in her descriptions. Guide her
through the disputation process as needed. This might be done while
she is relating her experiences by asking questions such as:
65
Do you think the belief is true? If so, why?
Discuss the role of circumstances that precipitate behavior. Tell the parent
that, as mentioned previously, a range of possible circumstances (referred
to as triggers, antecedents, or setting events) can prompt problem behav-
ior. These things can include physical discomfort, stressful situations,
withdrawal of attention, demands to do something, changes in routine,
and a variety of other issues. It is essential that these circumstancesand
those that prompt good behaviorbe identied so that a childs behavior
can be improved.
(If the parent describes ways in which she prompts problem behavior
through her interactions with the child [e.g., allowing anticipatory
stress to change how she interacts with her child, failing to plan ahead],
explore what she is thinking during those times and what impact those
thoughts might have.)
Explain that information obtained about the situations that seem to trig-
ger problem behavior can be used to rearrange the environment in ways
that can prevent problem behaviors from aring up. Have the parent ask
herself the following question: What could I change about this situa-
tion that would increase the chance that my child would behave better?
66
Avoiding Difficult Situations
67
helpful. (If the parent is nding that she is avoiding going places or
doing things that she would enjoy, explore what she is saying to herself
regarding those situations and whether those thoughts are benecial.)
Describe how to make situations that typically set the stage for problem
behavior better and, thereby, reduce problems. When it is not practical
or possible to avoid a task or situation that causes disruption, inserting
or embedding pleasant activities can make the whole task or situation
more enjoyable. Several examples of successful strategies include:
(If the parent has negative thoughts about the possibility of making
these changes, guide her through the disputation process.)
68
Children quickly pick up on tension and respond in kind. Changing ones
style of communication can trigger cooperation and pleasant interactions
rather than resistance and negative behavior from children.
Providing Choices
Discuss how oering choices and providing a child with more control
over tasks and situations can be an eective way of preventing problem
behavior and encouraging positive behavior. There are a number of areas
where parents often make decisions for children that the children could
be making for themselves. In fact, this could be contributing to their dis-
ruptive behavior. Providing more opportunities to make choices can
build independence skills and foster good decision-making, as well as
reduce problem behavior. Some examples of ways to provide choices to
children are to allow them to decide:
Explain that many children require help to know how to behave in par-
ticular circumstances. At rst a child might need an explanation about
what is expected in situations (e.g., You must use your inside voice
when at the store). Later on the child might still require prompts to
69
remember to use this skill when actually in the situation. Written
reminders or pictures (e.g., pictures on storage boxes to show where toys
should be placed) can be useful reminders for children who do not
require constant verbal prompts. Review how to establish predictability,
use schedules, and give warnings. Provide examples (e.g., schedules, cue
cards) as appropriate for the parents child.
(If appropriate, discuss what the parent might need to say to herself to ade-
quately anticipate and prepare for changesi.e., the preparation for poten-
tially dicult circumstances may need to be mental, not just physical.)
Predictability
We are going to the park. When we get there, I need you to hold my
hand while we are in the parking lot. You can climb on the jungle
gym, swing, and run around the playground, but you must stay on
the mulch. When it is time to leave the park, I want you to hold my
hand again while we go to the car. Afterward, if you have followed
these rules, we can stop for ice cream.
Scheduling
Younger children, those who have diculty with too much verbal
information, or those who tend to get anxious (and display problem
behavior) when routines change might benet from written or visual
70
schedules to clarify upcoming events and activities. If appropriate, dis-
cuss with the parent whether she might want to provide these kinds of
schedules for her child. Schedules might include pictures that illustrate
the typical daily routines or drawings of special activities on a calendar.
When routines have to change or a child is required to wait, these
things may be indicated visually on the schedule (e.g., by moving the
activity down the schedule).
Warnings
Some children have problems when an activity goes on too long or they
have to wait. In this case, parents might warn the child that the end is
near (e.g., Were almost done; I think you can stay in your seat and
play with your toys for ve more minutes). Parents can also use timers
or countdowns (e.g., 3 minutes, 2 minutes, 1 minute) when nearing the
end of an activity.
Present a sample hypothesis (see the following case example) and ask the
parent to identify the circumstances preceding problem behavior
(antecedents and setting events) and strategies to prevent problems that
include avoiding or improving dicult situations, providing choices,
and prompting good behavior. Discuss how these strategies might be
put in place. Share other examples as necessary and appropriate.
When Bens parents try to put his shoes on to leave the house, he
screams, cries, and drops to the oor. It is especially bad when he is tired.
The tantrum delays the transition, forces his mother to take him out
without shoes, or results in her canceling the errand or getting someone
else to do it.
71
Based on the summary statements for the case study, describe strategies
for preventing problems. The strategies might include avoiding prob-
lems, making dicult circumstances better, providing choices, or adding
cues to positive behavior. Provide visual examples of the strategies where
possible. Explain how prevention strategies might be faded over time as
the child gains skills necessary to cope with her circumstances.
Create a bag of special toys that Ben may take with him in the car when
he goes somewhere, and place a few of his favorites in the glove compart-
ment. Change out the toys periodically, and keep them only for transitions.
Schedule several dierent play sessions during and after school, and
include those sessions on Bens schedule. Alternate playing with mom or
teacher and playing independently (so that Ben can enjoy his time alone
during play also). Make the sessions very short, with only small attempts
to play with him (e.g., handing him a toy or simply playing with the toys
next to him without asking anything of him). Tell him exactly what you
want to do with him before play will be nished (e.g., after we nish this
puzzle together, I will let you play alone).
Have Ben eat meals and snacks only at the table. Provide Ben with
some of his favorite foods during breakfast and lunch (to encourage him to
eat). Prior to starting to prepare a meal, get Ben involved in an activity
he particularly likes to distract him from dinner preparation. Set the table
ahead of time, and do whatever preparations can be done earlier in the
day (when Ben is not hungry). When its time to eat, bring him to the
table explaining that he must sit to eat.
72
Application
(Discuss how self-talk might interfere with the parents ability to design
and implement strategies to prevent problems.)
Homework
Encourage parent to talk with family members and others to get their
input on prevention strategies.
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Chapter 7 Session 5: Managing Consequences
Materials Needed
Outline
Preview agenda
Review homework
Assign homework
Preview Agenda
Preview the agenda for this session. Review the brainstorming interven-
tions format (introduced in Session 3), pointing out which area will be
addressed during this session (managing consequences).
75
Homework Review
Ask the parent if he has any questions about the previous session or
the workbook readings. Review the homeworkidentifying precipi-
tating circumstances and choosing strategies to prevent problem
behavior. (If the parent did not generate additional prevention strate-
gies, prompt him to do so using one of his hypothesis statements and
record these on the homework forms.)
Review the parents Self-Talk Journal. Ask the parent to choose one
success and one diculty from the past week and share the entry
(including the situation, self-talk, and consequences of the self-talk).
Have the parent describe how he disputed or distracted himself from
pessimistic beliefs.
Using Affirmations
76
Application
Have the parent consider one or more of the entries in his Self-Talk
Journal and identify an armation he might use to substitute the
pessimistic thinking. (Ask, What could you say to yourself in that
situation?) Have the parent record the armation in column 5 of his
Self-Talk Journal as an example.
Throughout the session, help the parent to recognize his thoughts and
feelings, the circumstances that precipitate them, and the conse-
quences of those beliefs. Pay attention to the parents body language as
you discuss dierent topics. If the parent appears to be uncomfortable
or resistant, prompt him to identify his self-talk by saying something
like, You seem uncomfortable. What are you thinking right now?
Guide him through the disputation process when appropriate or
prompt him to use distraction (e.g., You are stating some negative
ideas; how can you stop them?). Prompt the parent to substitute
pessimistic thoughts with positive armations. These elements should
be blended throughout the session and not unnecessarily interrupt the
ow of the training.
Backing o from a demand because the child gets upset can also
reinforce the behavior because the child no longer has to com-
plete a seemingly unpleasant activity and, therefore, might cause
the child to act up again to avoid or escape demands.
77
Giving in to a request for a toy, food, or an activity because the child
becomes increasingly demanding or disruptive will make that behav-
ior worthwhile and, therefore, likely increase the probability that the
behavior will occur in the future.
(If the parent feels that his reactions to the child [e.g., giving in to placate
the child] might be inadvertently encouraging problem behavior, prompt
him to consider what he is saying to himself at the point when he reacts
that way and what results might be maintaining his own behavior.)
Managing Consequences
78
If a child seems to enjoy the behavior itself (i.e., it feels good),
nd other ways for the child to get that same kind of stimulation
(e.g., dancing, manipulating toys instead of rocking and apping
hands).
Present a sample hypothesis (see the following case example). Ask the
parent to identify the consequences that appear to be maintaining the
problem behavior (what the child gets or avoids) and strategies to
manage consequences that include providing rewards only following pos-
itive behavior and withholding positive consequences in response to
behavior problems. Discuss how these strategies might be put in place.
Share other examples as appropriate and necessary.
When Bens parents try to put his shoes on to leave the house, he
screams, cries, and drops to the oor. It is especially bad when he is
tired. The tantrum delays the transition, forces his mother to take
him out without shoes, or results in her canceling the errand or
getting someone else to do it.
Based on the summary statement for the case study, describe how to
respond to the childs behaviorto provide reinforcement when he
79
engages in positive or replacement behavior and to withhold reinforce-
ment when he engages in problem behavior. Be specic, and make sure the
example consequence strategies are functional and minimally intrusive.
Application
Using the hypotheses or summary statements the parent developed for his
child, repeat the preceding exercise. Refer back to the initial ideas for
managing consequences recorded in the center column of the completed
80
Brainstorming Interventions form from Session 3. Continue to develop
ideas for reinforcing positive behavior and avoiding rewarding problem
behavior. Have the parent record these ideas on the Managing
Consequences Worksheet. Consider how these strategies might be put
in place.
(Guide the parent to consider self-talk that may make it dicult for
him to be consistent in managing the consequences he has identied
and how he might replace that self-talk.)
Use of Punishment
81
removing access to more and more favorite things). This escala-
tion of punishment can be dicult to stop.
Homework
Encourage parent to talk with family members and others to get their
input on consequence strategies.
82
Chapter 8 Session 6: Replacing Behavior
Materials Needed
Self-Talk Journal
Outline
Preview agenda
Review homework
Assign homework
Agenda Preview
Preview the agenda for this session. Review the brainstorming interven-
tions format (introduced in Session 3), pointing out which area will be
addressed during this session (replacing behavior and teaching skills).
83
Homework Review
Ask the parent if she has any questions about the previous session or the
workbook readings.
Review the parents Self-Talk Journal. Ask the parent to choose one suc-
cess and one diculty from the past week and share the entry (includ-
ing the situation, self-talk, and consequences of the self-talk). Have her
describe how she disputed or distracted herself from pessimistic beliefs
and what positive statements (i.e., armations) she used for substitu-
tion. Note: the statements should be honest and practical and be stated
in present tense (e.g., I am a gentle, but rm, parent), focused on
solutions (i.e., state what will be done to resolve a situation), and be
both specic and comprehensive (i.e., clear and relate to various situa-
tions in which pessimistic beliefs are likely to arise).
Cognitive Restructuring
Have the parent consider one or more of the entries in her Self-Talk
Journal and work through the entire process. Have her evaluate how she
is doing with the cognitive restructuring strategies (e.g., What is work-
ing well? What isnt working? How will you do things dierently next
time?). Then have her record her impressions in the comments section
of the Self-Talk Journal.
84
like, You seem uncomfortable. What are you thinking right now?
Encourage her to use disputation and/or distraction and to substitute
pessimistic thoughts with positive armations. These elements should
be blended throughout the session and not unnecessarily interrupt the
ow of the training.
Replacing Behavior
85
If a child has diculty with certain activities, encourage her to ask
for help, switch to another activity, or take periodic breaks.
If a child acts out when wanting attention, teach her how to begin
an interaction (e.g., by touching a persons hand or holding up a
toy) or to get involved in another activity until a person becomes
available.
Social skills to use when interacting with other children (e.g., how
to join play or take turns in a game)
(If this discussion challenges the parents assumptions about skills the
child is capable of developing, explore her self-talk regarding the childs
capabilities.)
Explain that long-held habits can be dicult to change. Just as our own
patterns of behavior are hard to break, a child who is used to being
disruptive to communicate or to get her needs met might initially resist
eorts to change her behavior and feel frustrated that behaviors that
have worked previously are no longer working. For other, more appro-
priate behavior to replace problem behavior, the new behavior has to be
easy for the child to use and produce the same or similar outcomes. By
competing eectively with the problem behavior, a child learns that it
86
might be easier to get what she wants by using the new behavior rather
than the old, inappropriate behavior. The payo is as good or better
for the new behavior and, therefore, outweighs the benets of using the
problem behavior.
For example, a childs screaming when she doesnt get her way with her
parents might be very eective because they give in immediately to stop
the screaming. If the parents try to get the child to say in a full sentence
I want ____ please and she has diculty speaking, it will certainly be
easier for her to scream. In this situation, it might be more appropriate to
simplify the expectation and require the child only to point to the item.
The parents could later expect her to say the word and then speak in a full
sentence. This way the child can be immediately successful and will be
more likely to communicate in an appropriate manner.
Present a sample hypothesis (see the following case example) and ask the
parent to think about both the function of the problem behavior and the
circumstances precipitating it. Have her identify positive behavior that
would replace the problem behavior. Discuss how these strategies might
be put in place. Share other examples as necessary and appropriate.
When Bens parents try to put his shoes on to leave the house, he
screams, cries, and drops to the oor. It is especially bad when he is tired.
The tantrum delays the transition, forces his mother to take him out
without shoes, or results in her canceling the errand or getting someone
else to do it.
Based on the summary statements for the case study, describe behav-
iors that could be taught to replace the childs problem behavior. The
behaviors should achieve the same function as the problem behavior
(and/or allow the child to cope better with the circumstances). The
behaviors should be clearly dened and be ecient and eective. For
example, the following are ways Bens parents taught him new behav-
iors to replace his problem behavior.
87
Case Example: Replacing Bens Problem Behavior
Teach Ben to check his schedule prior to transitions. (The schedule will
be posted near his play area where he has access to it at all times.)
Have him put his puzzles or toys away prior to leaving.
Have him practice waiting for food for brief periods of time and
stopping activities to do something else (e.g., to wash his hands or wipe
his mouth). Encourage Ben to ask to continue activities: say, what do
you want? Help him point toward the activity and then say, Oh, you
want to play with the puzzle?
Practice playing with Ben by initially sitting beside him, then touch-
ing his toys, then handing him toys he needs, and eventually taking
turns with toys. Prompt him to say go or put his hand up when he
needs a break, and move away.
Have Ben practice eating at the table for short periods of time, provid-
ing praise and treats when he remains in his seat.
Application
(If appropriate, discuss any self-talk of the parent that would interfere
with the development of these skills for the child.)
88
Teaching Skills
Describe the basic steps for systematically teaching new skills, provid-
ing examples. The most important long-term approach for addressing
childrens behavioral concerns is to give them better ways to meet their
needs and handle dicult situations. In essence, positive behavior sup-
port is really about teachingguiding children to develop the skills
they need to be successful.
For many children, learning new behaviors takes more than simply
showing them or describing what we want them to do. Often times, new
skills must be presented in a systematic way for them to be eectively
learned. The following are steps for teaching skills (see case study for
examples of each step):
Step 1. Identify what exactly you want to teach (i.e., what you want your
child to say or do). Break it down into teachable units, and dene
the steps or components clearly. This is called a task analysis.
Step 2. Decide where, when, and with whom this skill is needed (e.g.,
when shopping in public, at meal times, or with grandparents).
Step 3. Arrange the environment to prompt the use of the skill, and
provide reminders, relying on natural cues whenever possible.
Step 5. Praise and reward use of the skill or progress in the right direction
(successive approximations). Correct errors, and withhold
rewards following mistakes and resistance.
89
Consider examples of goals for behavior, and discuss how the parent
would teach the required skills.
Step 1: Bens parents identied that they wanted to teach Ben to transition
from the house or classroom to the car by having Ben:
2. Walk to his schedule and point to the picture indicating the next
activity
Step 2: Bens parents decided this transitioning skill was needed any time
Ben must leave one place to go to another (e.g., from home, school,
or the store to the car).
Step 3: To provide cues for the skill, Bens parents put a small bag of
special car transition toys near the door but out of Bens reach.
They changed these toys periodically and whenever Ben seemed to
lose interest in them. Prior to each transition, they would point to
the bag and show Ben on his schedule where he would be going
(e.g., In a couple of minutes, we will be going to ____ ). They
also placed Bens shoes near the play area with the Velcro undone.
When it was time to leave, they would say, Time for ____
(e.g., school, store).
Step 4: Bens parents showed Ben the behavior they wanted from him.
Their plan was as follows:
90
They wait for him to respond to the cue or prompt. If he still
continues to play, they gesture and move the toy bin or
container closer, saying Put away ____ (and pointing in the
container).
Step 5: Bens parents praised him frequently for putting his toys away
(even if the toy had to be put in hand-over-hand), getting up
and moving toward the door, picking up his toy bag, and leaving
his shoes on (e.g., Wow, you did it! You are walking with
mommy). If Ben made it to the car without a tantrum, they
gave him an extra toy (kept in glove compartment). Once in the
car, they said something every minute or two about sitting nicely
in the car. When he arrived at his destination without a
tantrum, they provided a special treat (e.g., fun activity at
school, treat on the errand). They made a schedule to show him
what he would get upon arrival to school. If Ben threw a
tantrum, they continued the sequence described in Step 4 and
made sure all toys got put away so there was complete closure
to activities. They would say one more puzzle piece or one
more animal, then we go. They ignored screaming, crying,
and dropping to the oor. They would say, It is hard to stop
playing. You can play later. They moved him through each
step with as little delay as possible, reassuring him along
the way.
Step 6: Bens parents waited longer and longer (e.g., adding a few seconds
each time) to praise or help Ben to put away his toys and get his
shoes on. They praised him for spontaneously using his schedule.
In the beginning, they limited transitions only to things Ben has
to do (e.g., school) or really likes to do (e.g., swimming), then
gradually added more activities.
91
Application
Refer to the ideas the parent listed on the Replacing Behavior Worksheet.
Consider which replacement behaviors require systematically teaching the
child new skills. Choose one, and work through the preceding steps,
recording the information on the Teaching Plan form. (If appropriate,
discuss any self-talk of the parent that would interfere with the develop-
ment of these skills for the child.)
Homework
Have parent complete the Teaching Plan form. The parent should try
teaching skills and observe their impact on the childs behavior.
Encourage parent to talk with family members and others to get their
input on replacing behavior and teaching skills.
92
Chapter 9 Session 7: Putting the Behavior Support Plan
in Place
Materials Needed
Self-Talk Journal
Outline
Preview agenda
Review homework
Assign homework
Agenda Preview
Preview the agenda for this session. Explain that the focus of the session
will be on how to put the behavior support plan in place. The content
will include putting the plan into a usable format, choosing strategies
93
that t the child and family, considering how the plan creates lifestyle
change, and making sure we have what we need to put our ideas into
action.
Homework Review
Ask parent if he has any questions about the previous session or the
readings. Review the homeworkselecting replacement behaviors and
eorts to teach skills. (If the parent did not generate additional strate-
gies for replacing the childs behavior, prompt him to do so using one
of the hypothesis statements and record these on the homework forms.)
Review Self-Talk Journal, and ask the parent to choose one success and
one diculty from the past week and share the entry (including the
situation, self-talk, and consequences of the self-talk). Have the parent
describe how he disputed or distracted himself from pessimistic beliefs
and what positive statements (i.e., armations) he used for substitution.
Have the parent review his entire Self-Talk Journal (every form) and
look for themes or patterns. Ask him to evaluate how he is doing with
his self-talk (e.g., What is working well? What isnt working? How
will you do things dierently next time?). Have him record his
impressions in the comments section of his Self-Talk Journal.
94
elements should be blended throughout the session and not unnecessar-
ily interrupt the ow of the training.
Integrating Components
95
3. Strategies for systematically teaching replacement skills so that the
childs needs can be met through more appropriate means where
and when they are needed
Review the behavior support plan for the case study of Ben (see
Figure 9.1.; a copy is provided in the workbook). If using another
example, provide a copy of a sample plan. The plan should include
(at minimum) goals, target behaviors, summary statements, strategies
for preventing problems, strategies for managing consequences, skills
for teaching replacement behavior, and a monitoring plan.
Application
96
Behavior Support Plan: Part 1
Broad Goals: How would you like life to improve for your child and family?
Ben will play with other children and adults, handle transitions and change better, and ride in the car
and eat with the family without problem behavior.
Ben will develop more interests (beyond animals and puzzles) and participate in typical childhood
experiences, including spending time with friends.
Ben will become more independent with his self-care, sleep alone, and develop the skills he needs
to keep himself safe (e.g., looking out for traffic).
Bens parents will be able to enjoy life as a family without the constant stress presented by his
problem behavior. They hope to be able to go places and do more things as a family and to reduce
the conflict in their lives.
When his parents or peers try to play with Ben, he screams and cries; if they dont back off, he
turns his back on them or pushes them away. Eventually, the children or family members back off,
and Ben is able to continue playing contentedly by himself.
When Ben doesnt eat well at breakfast and lunch, he screams and cries as dinnertime approaches.
If Bens mother doesnt feed him right away, he might bang his head. As a result, she quickly
prepares him something he likes to eat. She often allows Ben to carry his food around (rather than
requiring him to sit with the family during meals).
Figure 9.1
Example of Completed Behavior Support Plan
97
Behavior Support Plan: Part 2
Intervention Components: What strategies will be used (based on the summary statements)?
Prevention: What changes Management: How will you Replacement: What skills will
will be made to avoid prob- respond to reward positive be taught to replace the prob-
lems, make dicult situations behavior and not problem lem behavior?
better, or prompt good behavior? Encourage Ben to ask for
behavior? If Ben asks for a delay in a brief delay in transitions
Set up a schedule with pic- a transition or a break from by putting his hand up or
tures of Bens typical daily play appropriately, back off pointing to a toy (to indi-
activities. Prior to transitions, for one minute, saying, cate he wants to continue
remind him of where he will okay, you need space/one play). To prompt him, say,
be going by pointing to that minute. What do you want? and
picture on his schedule. Praise Ben for transitioning guide him through the
Explain what he needs to do and tolerating others playing movement.
during the transition, using with him. Praise every action Teach Ben to check
consistent words. Remind him he does well. Provide small his schedule prior to transi-
of fun things he can do or rewards for going places and tions. Have him put his toys
treats he will receive where doing things without away prior to leaving.
he is going. tantrums. Have Ben practice waiting
Create a bag of special toys During a transition, if Ben for food for brief periods
that Ben may take with him refuses to leave or drops to of time and stopping activi-
on outings, and place a few of the floor, guide him gently ties to do something else.
his favorites in the glove com- but firmly to leave. Do not Encourage Ben to ask to
partment. Change out the toys delay the transition. Ignore continue by saying to him,
periodically, and keep them crying and screaming. what do you want? Help
only for transitions. If he plays without crying him point toward the activ-
Schedule play sessions during and screaming for a short ity and then say, Oh, you
and after school. Alternate period, ask him if he would want to play with
playing with others and play- like to be alone, prompt him puzzle/animals.
ing independently. Make the to say go, and leave. Teach Ben to tolerate play
sessions very short, with only Gradually extend the time with other people by sitting
small attempts to play with he is expected to play before beside him, touching his toys,
him or simply playing with asking someone to go. If he handing him toys, and even-
the toys next to him without begins to cry or scream tually taking turns with the
demands. Tell him exactly during play, remain in the toys. Prompt him to say go
what you want to do with area until he asks go. or put his hand up when he
him before ending playtime. Allow Ben to leave the needs a break.
98
Behavior Support Plan: Part 2
Intervention Components: What strategies will be used (based on the summary statements)?
Have Ben eat meals and table during meals, but ask Have Ben practice eating at
snacks only at the table. him to put his food down the table for short periods
Provide Ben with some of his before he goes. If he refus- of time.
favorite foods during break- es, remove the food. When Teach Ben daily living skills,
fast and lunch. Before meal he is seated, return the such as tooth brushing and
preparation, get Ben involved food. Reward Ben for eat- potty training.
in an activity. (Set the table ing at the table with his
ahead of time, and do what- favorite foods.
ever preparations can be done
earlier in the day). When its
time to eat, bring him to the
table explaining that he must
sit to eat.
Crisis Management:
Is a plan needed to ensure the safety of your child, other people, and the surroundings? __X
__yes__no
If so, describe strategies:
If necessary, physically guide or carry Ben out of public places or unsafe situationsbeing careful to be
gentle but firm.
Other Support: What else can improve life for your child and your family?
Take Ben out to new places (e.g., a water park, playground, convenience store) periodically.
Find peers in the neighborhood and at school to play with Ben weekly; teach the children how to
enter his play without upsetting him.
Develop a plan for teaching Ben to use the potty (e.g., creating a schedule, using rewards) and self-
care skills (e.g., washing hands). Institute a regular bedtime routine.
Locate a babysitter for weekend dates. Become involved in a support group in the community.
99
Behavior Support Plan: Part 3
Monitoring :
How often will the plan be monitored? __x__daily __x__weekly __monthly __other
How will implementation and outcomes be evaluated?
Continue using scatterplot and ABC recording forms to evaluate changes in behavior. Keep
a daily journal that includes particularly successful and unsuccessful transitions, results of
attempts to play with Ben, and estimated times Ben remains at the dinner table. Meet
briefly with Bens teacher at the end of the school day on Fridays to discuss progress and
decide on changes to be made.
Monitoring methods (e.g., forms): Scatterplot, Behavior Log
100
Whether behavior support plans are implemented as designed depends
on the commitment of the people using the plan and the degree to which
strategies are really doable. What we do to address a childs behavior
should be determined based on a consideration of resources and natural
patterns of family life. Things that need to be taken into account include:
Assess the degree to which the plan ts the child and family by look-
ing back at the strategies identied and considering the following
questions:
3. Does the team have the resources it needs to make the plan
work?
Describe issues associated with contextual t for the case study child
and family, pointing these out in the behavior support plan. This
101
should include any factors that would aect the design or implemen-
tation of the plan.
The primary challenges for Bens family were getting everyone on the
same page (including Grandma) and managing all the individual tasks
associated with the plan. It was important to make sure everyone had the
same goals and expectations and was adequately supported. Bens team
(parents, grandma, and teacher) agreed to meet and go over the plan
together, discussing any concerns, making sure everyone understood what
he or she was doing and why, and making adjustments to the plan as
needed to ensure buy-in. Then they all promised to follow through and
communicate openly about their concerns as time went by. They also dis-
cussed the fact that it might take time for the plan to work and that they
all needed to be patient. Bens mom talked to his teacher about how
overwhelmed she was with trying to create his schedule. His teacher
agreed to help Mom put it together after school while Dad watched Ben.
Bens mom found that trying to carry all of the dierent items to the car
was dicult, so she bought an oversized bag to use during transitions.
Remind the parent that the primarily goal of positive behavior support
is not just to diminish problems but also to promote positive lifestyle
change. Discuss issues that should be considered in making sure that a
plan focuses on these broader goals. As we develop plans to address a
childs behavior, it may become evident that broader life issues are
aecting the childs behavior and will, therefore, need to be addressed
to produce positive changes. For example, if a child (or adult) is gen-
erally dissatised with the types of activities or circle of friends with
whom he interacts, those circumstance produce worse behavior over-
all. Some questions we might want to think about are:
3. Do the childs current schedule and daily routines match his pre-
ferred style?
102
4. Are there aspects of the childs surroundings that need to be
changed?
Describe strategies for the case study directed at improving the broader
quality of life for the child or family (e.g., related to independence,
community participation, relationships), pointing out these things in
the behavior support plan.
Bens parents decided to start trying to take Ben out to new places (e.g., a
water park, playground, convenience store) once in a while to expose him
to new things. They also found a child from the neighborhood who was
willing to come over once a week to play with or around Ben; Bens
mom taught the child how to enter his play without upsetting him. The
same was done at school by his teacher with a child from another class.
Bens parents and teacher worked together to develop a plan for teach-
ing him to use the potty (e.g., creating a schedule, using rewards), and
they identied self-care skills (e.g., washing hands) they could teach
together using the steps for teaching skills described in Session 4. His
parents also instituted a regular bedtime routine to create a more con-
sistent, positive transition to bed at night.
103
Application
Work with the parent to integrate all elements of the behavior sup-
port plan using the Behavior Support Plan form. Discuss issues relat-
ed to contextual t and identify strategies for lifestyle change while
constructing the plan. (If appropriate, ask the parent what he might
need to say to himself to believe in the plan and, therefore, follow
through.)
Explain the rationale for creating an action plan for getting the behavior
support strategies into place. Discuss issues that should be considered,
and provide examples. Explain that once we are satised with our plan for
dealing with a childs behavior, certain steps need to be taken to
implement the plan with some degree of consistency. Consistency is
important because hit and miss use of behavioral strategies can actually
be detrimental because problem behaviors could sometimes end up being
reinforced. To get the plan in place, it may be necessary to line up sup-
port from extended family, friends, babysitters, or teachers and to consid-
er how to draw in extra assistance for times that are too dicult to handle
alone. Preparations might also include changing schedules, setting up
methods to record changes in behavior over time, rearranging things at
home, or making other modications that can reduce some of the stress
associated with implementing the plan. By doing this type of preplan-
ning, the behavior support plan will be easier to put in place and adhere
to over time. (If the parent addresses attitudinal barriers that might inter-
fere with the plans implementation, ask him what steps need to be taken
to revise those beliefs.)
1. Review the plan, and get a commitment from other people who care
for Ben (e.g., family members, teachers) to carry out the plan.
104
2. Work with Bens teacher to create a schedule for home and school that
includes transitions and play times. Decide beforehand who will get
what materials (e.g., Bens mother will get poster board, pictures of
settings or things that can represent activities for home, toys for the
bag, and some other reward to leave with the teacher; teacher will
take photographs of activities at school, get pictures of possible
rewards, and laminate the schedule for home and school).
4. Meet briey at the end of the school day on Fridays to discuss progress
and decide on changes to be made.
Application
Guide the parent to identify one or more action steps that need to be
implemented and to record them on his Behavior Support Plan form.
Homework
Encourage parent to talk with family members and others to get their
input on behavior and action plan steps.
105
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Chapter 10 Session 8: Monitoring Results and Wrap-up
Materials Needed
Self-Talk Journal
Monitoring Form
Outline
Preview agenda
Review homework
Agenda Preview
Preview the agenda for this session. Explain that the focus will be on
determining how to monitor the implementation and results of the
behavior support plan and making adjustments as needed to sustain the
outcomes over time.
107
Homework Review
Ask the parent if she has any questions about the previous session or the
workbook readings. Review the homeworkcomprehensive behavior
support plan, action plan for putting it in place, status of implement-
ing strategies and outcomes. (If the parent did not complete the behav-
ior support plan and action plan, assist her in recording at least the most
essential information.)
Have the parent review all her Self-Talk Journal sheets from the past
seven weeks and look for general themes and patterns. Ask her to
evaluate how she is doing with her self-talk (e.g., What is working
well? What isnt working? How will you do things dierently next
time?). Have her then record her impressions in the comments section
of the Self-Talk Journal. Help her to identify strategies to maintain
positive changes in self-talk (e.g., ongoing monitoring and feedback) or
to continue evaluating and addressing self-talk now that the sessions
will be ending.
108
Monitoring Results of the Plan
The goals of PBS, and therefore the target areas for monitoring, are not
only reductions in problem behaviors but also broader outcomes
related to a childs and familys quality of life. Here are some questions
to ask when monitoring results:
Is the behavior support plan still working for the child and family
(i.e., does it t the circumstances and needs)?
109
to be very complicated, it may be benecial to create a more involved
recording system. The people involved in using the plan could meet
periodically and look at the goals and target behaviors together to
evaluate broader outcomes.
Generally, the methods and timeline used should be based on how often
problems occurred before the plan was implemented. With this in
mind, we need to decide how often we will review the plan and out-
comes (e.g., if the child is hitting others on a daily basis, we would want
to review the data more often than for a child who has weekly
tantrums).
Describe how the plan for the case study child could be monitored to
evaluate its eectiveness over time. Include the specic monitoring
strategies and schedule.
A daily journal including when, where, and with whom Ben made
transitions and his accompanying problem behaviors
A brief log of their attempts to play with Ben (i.e., what they were
able to do with him)
Application
Have the parent review the data she has collected to this point and
develop a plan for monitoring how the behavior support plan is used
and its outcomes for her child and family. Refer the parent to the
Monitoring Plan Worksheet in the workbook. Also have her consider
110
when and how she will communicate with her family members and
others involved in her childs care to assess progress. Parents might want
to use the Monitoring Form provided in the workbook to track the
results of the behavior support plan.
Parents and others caring for the children should be continually asking
themselves what is working and what is not, and adjusting the plan as
needed. As time passes and children continue to develop, their needs and
the situations aecting their behavior change. Families might go through
transitions or life experiences that throw a wrench into the works. It is
important to recognize that changes in routines, circumstances, or lives
in general can prompt changes in childrens behavior. And as children go
through typical developmental changes (e.g., developing friendships,
starting school, learning new skills) or other unanticipated events, their
needs, and therefore our approach to dealing with them, will necessarily
change.
Parents need to take note of such changes and the impact they have on a
childs behavior, and they must be prepared to deal with them. Better yet,
they should anticipate and prepare for changes (e.g., taking children to
visit their new teachers, building the skills they need to play with friends),
avoiding unnecessary problems when possible. Parents can use the frame-
work of PBS and its tools over and over, repeating the process as needed.
In this way, parents can eectively support their children as they
encounter new situations and phases of their lives.
111
Case Example: Outcomes of Bens Plan
Within three weeks of putting the plan in place, Bens screaming and
crying during most transitions decreased just to whining and occurred
only about three times per week (and no longer than 30 seconds each
time). When Ben started speech therapy, however, transitions again
became a problem. When Ben knew he was headed to speech therapy at
either home or school, his tantrums escalated in severity and were much
longer. His parents, teachers, and therapists met to discuss this concern.
They reviewed the circumstances surrounding his behavior and possible
consequences. They determined that speech was particularly diicult for
Ben and decided to make some changes to reduce the demands. The strate-
gies included starting therapy sessions with activities they knew to be easier
for Ben, giving Ben periodic breaks, and adding special rewards when he
transitioned and participated well. These strategies were quite successful.
During play times, his mother and teacher were now able to sit with
him while he was playing and pick up and hand him toys. He usually
allowed them to remain with him for about two to three minutes
before saying go. He still wandered around the dinner table, but he
began putting his food down before leaving without reminders. His
parents were hopeful that he would start sitting with the family before
long. Ben even looked at his schedule and put his toys away sponta-
neously. He seemed to enjoy the predictability of knowing where he was
going and what would happen when he got there. Because of these
improvements, his parents felt condent beginning to expose Ben to
new people and places and tackling new skills such as sleeping alone
and potty training.
Application
112
Also, identify one or more ways the parent can continually assess the
plan, resolve problems, and make adjustments as needed. Have parents
record this information on the Monitoring Plan Worksheet.
113
Behavior support plans must be monitored objectively on an
ongoing basis to determine their eectiveness and recognize when
adjustments are necessary.
114
PBS Resources
Books/Articles
Carr, E. G., Dunlap, G., Horner, R., Koegel, R. L, Turnbull, A. P., Sailor,
W., Anderson, J. L., Albin, R. W., Koegel, L. K., & Fox, L. (2002).
Positive behavior support: Evolution of an applied science. Journal of
Positive Behavior Interventions, 4(1), 416.
Carr, E. G., Levin, L., McConnachie, G., Carlson, J. I., Kemp, D. C., &
Smith, C. E. (1994). Communication-based intervention for problem
behavior: A users guide for producing positive change. Baltimore, MD:
Paul H. Brookes Publishing.
Durand, V. M. (1990). Severe behavior problems: A functional communica-
tion training approach. New York: Guilford Press.
Durand, V. M. (1998). Sleep better! A guide to improving sleep for children
with special needs. Baltimore, MD: Paul H. Brookes Publishing.
Hieneman, M., Childs, K. E., & Sergay, J. (2006). Parenting with positive
behavior support: A practical guide to resolving your childs dicult
behavior. Baltimore, MD: Paul H. Brookes Publishing.
Hieneman, M., Nolan, M., Presley, J., De Turo, L., Roberson, W., &
Dunlap, G. (1999). Facilitators guide: Positive behavioral support. Positive
Behavioral Support Project, Florida Department of Education.
Koegel, L. K., Koegel, R. L., & Dunlap, G. (1996). Positive behavior sup-
port: Including people with dicult behavior in the community.
Baltimore, MD: Paul H. Brookes Publishing.
Lucyshyn, J. M., Dunlap, G., & Albin, R. W. (2002). Families and positive
behavior support: Addressing problem behavior in family contexts.
Baltimore, MD: Paul H. Brookes Publishing.
ONeill, R. E., Horner, R. H., Albin, R. W., Sprague, J. R., Storey, K., &
Newton, J. S. (1997). Functional assessment and program development
for problem behavior: A practical handbook. Pacic Grove, CA:
Brooks/Cole.
115
Scotti, J. R., & Meyer, L. H. (1999). Behavioral intervention: Principles,
models, and practices. Baltimore, MD: Paul H. Brookes Publishing.
Sugai, G., Horner, R. H., Dunlap, G., Hieneman, M., Lewis, T. J., Nelson,
C. M., Scott, T., Liaupsin, C., Sailor, W., Turnbull, A. P., Turnbull,
H. R., Wickham, D., Ruef, M., & Wilcox, B. (1999). Applying positive
behavioral support and functional behavioral assessment in schools (TAG 1).
OSEP Center on Positive Behavioral Interventions and Supports.
Web Sites
116
Session 1: Introduction and Goal Setting
Client Name: _________________________ Date: ______________
Rate your delity to each session element on a scale of 1 to 7, with 1 indicating poor delity
and 7 indicating high delity.
___Give background and denition of positive behavior support (PBS) as foundation of the
program
___Assign homework
Notes:
117
Session 2: Gathering Information
Client Name: _________________________ Date: ______________
Rate your delity to each session element on a scale of 1 to 7, with 1 indicating poor delity
and 7 indicating high delity.
___Preview agenda
___Review homework
___Assign homework
Notes:
118
Session 3: Analysis and Plan Design
Client Name: _________________________ Date: ______________
Rate your delity to each session element on a scale of 1 to 7, with 1 indicating poor delity
and 7 indicating high delity.
___Preview agenda
___Review homework
___Assign homework
Notes:
119
Session 4: Preventing Problems
Client Name: _________________________ Date: ______________
Rate your delity to each session element on a scale of 1 to 7, with 1 indicating poor delity
and 7 indicating high delity.
___Preview agenda
___Review homework
___Assign homework
Notes:
120
Session 5: Managing Consequences
Client Name: _________________________ Date: ______________
Rate your delity to each session element on a scale of 1 to 7, with 1 indicating poor delity
and 7 indicating high delity.
___Preview agenda
___Review homework
___Assign homework
Notes:
121
Session 6: Replacing Behavior
Client Name: _________________________ Date: ______________
Rate your delity to each session element on a scale of 1 to 7, with 1 indicating poor delity
and 7 indicating high delity.
___Preview agenda
___Review homework
___Assign homework
Notes:
122
Session 7: Putting the Behavior Support Plan in Place
Client Name: _________________________ Date: ______________
Rate your delity to each session element on a scale of 1 to 7, with 1 indicating poor delity
and 7 indicating high delity.
___Preview agenda
___Review homework
___Assign homework
Notes:
123
Session 8: Monitoring Results and Wrap-up
Client Name: _________________________ Date: ______________
Rate your delity to each session element on a scale of 1 to 7, with 1 indicating poor delity
and 7 indicating high delity.
___Preview agenda
___Review homework
Notes:
124
References
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Byrd, R. S., & Weitzman, M. L. (1994). Predictors of early grade retention
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Carr, E. G. (2007). The expanding vision of positive behavior support:
Research perspectives on happiness, helpfulness, and hopefulness.
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Carr, E. G., Dunlap, G., Horner, R. H., Koegel, R. L., Turnbull, A. P., Sailor,
W., Anderson, J. L., Albin, R. W., Koegel, L. K., & Fox, L. (2002).
Positive behavior support: Evolution of an applied science. Journal of
Positive Behavior Interventions, 4(1), 416.
Carr, E. G., Horner, R. H., Turnbull, A. P., Marquis, J. G., McLaughlin,
D. M., McAtee, M. L., Smith, C. E., Ryan, K. A., Ruef, M. B., &
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Carr, E. G., & Durand, V. M. (1985). Reducing behavior problems through
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Carver, C. S., & Scheier, M. F. (1990). Origins and functions of positive
and negative aect: A control process view. Psychological Review, 97,
1935.
Clarke, S., Dunlap, G., & Vaughn, B. (1999). Family-centered, assessment-
based intervention to improve behavior during an early morning rou-
tine. Journal of Positive Behavior Interventions, 1, 235241.
Cole, D. A., & Meyer, L. H. (1989). Impact of needs and resources on fam-
ily plans to seek out-of-home placement. American Journal on Mental
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Conners, C. K. (1997). Conners rating scales-revised. Toronto, Canada:
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Day, H. M., Horner, R. H., & ONeill, R. E. (1994). Multiple functions of
problem behaviors: Assessment and intervention. Journal of Applied
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Delprato, D. (2001). Comparisons of discrete trial and normalized behav-
ior intervention for young children with autism. Journal of Autism and
Developmental Disabilities, 31, 315325.
Dunlap, G., & Fox, L. (1999). A demonstration of behavioral support for
young children with autism. Journal of Positive Behavior Interventions,
1, 7788.
Dunlap, G., Hieneman, M., Knoster, T., Fox, L., Anderson, J., & Albin,
R. (2000). Essential elements of inservice training in positive behav-
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Dunlap, G., Kern-Dunlap, L., Clarke, S., & Robbins, F. R. (1991).
Functional assessment, curricular revision, and severe behavior prob-
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About the Authors
His published works include numerous books and more than 100 other
research publications. One book, Severe Behavior Problems: A Functional
Communication Training Approach, is the product of 10 years of empirical
research and outlines a novel treatment for problem behavior using com-
munication. Dr. Durand developed the Motivation Assessment Scale, a
functional behavioral assessment instrument that is now translated into 15
languages. He has also authored several bestselling textbooks, including
Abnormal Psychology: An Integrative Approach, and he published the rst
book on sleep disorders for children with disabilitiesSleep Better! A
Guide to Improving Sleep for Children with Special Needs. Dr. Durand
serves on the editorial boards of several journals, including Clinical
Psychology Review, Journal of Developmental and Physical Disabilities,
Journal of Positive Behavior Interventions, and Focus on Autism and Other
Developmental Disabilities. He was recently elected to the Panel of
Professional Advisors for the Autism Society of America.
133
She has a PhD in Special Education and is nationally certied as a
behavior analyst. She has published a variety of articles and chapters in
the area of positive behavior support (PBS) and is the lead author of a
book titled Parenting with Positive Behavior Support: A Practical Guide
to Resolving Your Childs Dicult Behavior.
134