I believe and overwhelming research confirms that it is better to focus on increasing a behavior than decreasing one; but sometimes, there are behaviors that can not be totally ignored and must be addressed for safety reasons. (Please see What is an Asset? http://communitycollaboration.blogspot.com/2007/11/what-is-asset.html for additional information on assets vs deficits.) Sometimes you may want to do this, not because it is a particular focus, but because you want to gather valid and reliable data regarding the behavior.
Remember:
Conduct a functional assessment (see functional assessment under Writing a Plan for Problem Behaviors http://bestoutcomes.blogspot.com/2008/05/writing-plan-for-problem-behaviors.html ) to determine, as much as possible, and continually adjusting with additional information, what the functional purpose is of the problem behavior. Sometimes, a problem behavior becomes the most efficient way for a person to get their needs met.
Write a program/plan to provide an alternative and more appropriate way to achieve the same and underlying appropriate outcomes. If you look deep enough, there will be a basic and underlying reason for the behavior that can be fulfilled through another behavior.
Spend as much time as possible working on increasing positive behaviors. Ideally you should spend at least three times as much of the program time on increasing behaviors as on decreasing behaviors.
Click here for more information on writing measurable behavioral objectives
Friday, June 20, 2008
Monday, June 16, 2008
Additional Resources for Measurable Behavioral Objective writing
Wednesday, June 11, 2008
CLASSIFICATION OF INTERVENTIONS FOR YOUNG CHILDREN WITH AUTISM SPECTRUM DISORDER *
Excerpts from:
AUTISM SPECTRUM DISORDER WORKGROUP
CLASSIFICATION OF INTERVENTIONS FOR YOUNG CHILDREN WITH AUTISM SPECTRUM DISORDER *
January 2007
Provided by Dr. Richard Solomon (P.L.A.Y. Project)
Early Intensive Behavioral Intervention (EIBI)
Comprehensive behavioral programming that aims to improve socially important behavior by using interventions that are based upon principles of learning theory (i.e., Applied Behavior Analysis) and that have been evaluated in experiments using reliable and objective measurement. EIBI methods are intended to increase behaviors (e.g. on-task behaviors, social interactions) teach new skills (e.g., life skills, communication skills, or social skills), maintain existing behaviors, generalize or transfer behavior across situations or responses, and to restrict or narrow conditions under which interfering behaviors occur and reduce interfering behaviors. (e.g., self injury or stereotypy). Individual curricula and teaching approaches may vary but commonly used approaches include the UCLA model (Discrete Trial Training, Applied Behavior Analysis) and Applied Verbal Behavior (VB).
http://www.behavior.org/autism/index.cfm?page=http%3A//
http://www.cofeat.org/data/201/documents/ParentsPacket2005January.pdf
Learning experiences: An Alternative Program for Preschoolers and Parents (LEAP)
LEAP was originally established as a federal demonstration program in 1982 at the University of Colorado School of Education. LEAP includes a Preschool component and a behavioral skill-training program for parents. The Preschool curriculum provides opportunities for learning related to social, emotional, language, adaptive behavior, cognitive, and physical development. The preschool setting includes typically developing children and peers with autism. This program has been shown to be effective for students with and without disabilities. The research suggests that this program produces improvements in social and language skills.
Pivotal Response Training (PRT)
PRT is a behavioral treatment intervention based on the principles of applied behavior analysis (ABA). Researchers have identified two pivotal behaviors that affect a wide range of behaviors in children with autism: motivation and responsivity to multiple cues. These behaviors are central to a wide area of functioning, so positive changes in these behaviors should have widespread effects on other behaviors. Thus PRT is able to increase the generalization of new skills while increasing the motivation of children to perform. PRT works to increase attempts and interspersing maintenance tasks. PRT has been used to target language skills, play skills and social behaviors in children with autism.
http://psy.ucsd.edu/autism/prttraining.html
http://www.dbpeds.org/articles/index.cfm
Positive Behavior Supports (PBS)
Positive behavior support (PBS) is the application of behavior analysis in the assessment and reengineering of environments so people with challenging behaviors: Experience reductions in their problem behaviors; learn how to replace inappropriate behaviors with acceptable appropriate behaviors; and increase social, personal, and professional qualities in their lives.
PBS emphasizes the development and implementation of individually tailored support plans that focus on proactive and educative approaches.
The PBS process involves engineering the environment to prevent problems from occurring; teaching individually acceptable alternative behaviors to replace problem behaviors; and consistently providing for positive consequences that encourage appropriate behavior outcomes over time.
Pyramid Approach: includes using Picture Exchange Communication System (PECS)
One of the methods used under an ABA approach, PECS uses pictures and other symbols to develop a functional communication system. PECS teaches students to exchange a picture of a desired item for the actual items (e.g., requisting). The application of ABA methods to teach PECS is an appropriate intervention for children with ASD who have limited or no communication skills. To increase the utility of this intervention, an important area for future research is to investigate PECS procedures for promoting initiation of communication and acquisition of complex, flexible language.
http://www.pecs.com/
Hanen Program/More Than Words
Integrates more traditional behavioral approaches with developmental, social-pragmatic approaches into a single program.
Does not replace the need for an intensive intervention program, rather it provides parents with practical tools for facilitating social and communication skills in their young child with ASD; parent training is considered an effective practice for early intervention.
Parents are extensively involved in their child’s intervention program, which can be more appropriate and effective, and less expensive than direct speech/language therapy for very young children.
Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH)
The foundation of this structured teaching intervention is the modification of the environment to assist the child in the learning process. The focus of this intervention is on organizing the child’s physical environment to facilitate overall task success, capitalizing on visual strengths typically displayed by students with ASD and minimizing reliance on auditory processing/verbal expression. Visual schedules are used to describe sequence of activities, work systems are used to teach students to work independently and task organization provides information regarding how to perform task.
http://www.teacch.com/
Denver Model
Denver Model is a developmentally oriented approach for preschool age children. Focus of intervention is on intensive teaching and developing social-communicative skills. Provided in home setting, inclusive preschool programs & in one-to-one direct instruction. The skills to be targeted are determined by the family in collaboration with the intervention team.
Developmental, Individual difference, Relationship based (DIR) Including Floortime, Play Project & Responsive Teaching
Social Pragmatic Interventions (SPI). Focus on reciprocal, contingent interactions. Play-based, child led and structured by developmental level of child.
Well-structured parent training approaches. Manual includes extensive training materials.
P.L.A.Y. Project
http://www.playproject.org/
ECO/Communication Partners
Emphasizes importance of parent education and involvement – parent child interactions are viewed as the primary opportunity for teaching young children to talk.
Aims to prevent speech and language delays by treating infants and preverbal children to ensure healthy development of socialization and communication.
Focuses on social-pragmatic language skills rather than simply building the size of the child’s vocabulary.
Targets children who are considered to be at high risk for speech and language problems.
http://jamesdmacdonald.org/Articles/MacDonaldStart.html
Gentle Teaching
Gentle Teaching is a philosophical approach that addresses how caregivers interact with individuals with disabilities. This approach can be used with persons of all ages and with various disabilities. The focus of Gentle Teaching is to create a bond between the person with a disability and their caregiver as a means to promote positive changes. This method is opposed to the use of punishment and physical restraint.
http://www.gentleteaching.nl/
Music Therapy
Refers to the application of music with the intent to enhance functioning. It consists of using music therapeutically to address behavioral, social, psychological, communicative, physical, sensory-motor, and/or cognitive functioning. The music therapist involves clients in sensing, listening, moving, playing instruments, and creative activities in a systematic, prescribed manner to influence change in targeted responses or behaviors and help clients meet individual goals and objectives. Musical activities may also be highly preferred for an individual with autism (e.g., listening to music, dancing, playing an instrument). Access to such activities may be used as a reward; this is different from music therapy, in which the musical activities themselves are viewed as therapeutic.
http://www.musictherapy.org/
http://www.autism.org/music.html
Prompt
Seeks to understand sensory-motor systems and how these systems function in typical and delayed/disordered child development.
PROMPT therapists do not use oral-motor exercises, speech drills, or traditional speech development hierarchy.
PROMPT therapists do utilize tactile-kinesthetic information to improve motor control, and facilitate the development of functional cognitive, social, and communication skills.
PROMPT provides treatment individualized to each person’s specific needs.
http://www.promptinstitute.com/
Relationship Development Intervention
Relationship Development Intervention is an ongoing program of clinical development and research begun in 1996. The primary goal of RDI is to remediate the recognized core deficits of ASD. RDI provides individuals with ASD the cognitive, emotional, communicative and social tools that are geared towards remediation rather than compensation. Recognized deficits of individuals with ASD include emotional referencing, social co-regulation, experienced based communication, autobiographical or episodic memory, executive functioning and dynamic thinking. RDI is a family centered treatment program that prepares parents to act as ‘participant guides’, creating daily opportunities to remediate the developmental deficits of ASD. The provider undergoes an eighteen month internship in the program in order to become certified.
http://www.rdiconnect.com/
Sensory Integration (SI) Therapy
SI refers to how an individual’s nervous system, including the five senses of pain, vision, taste, smell and hearing, receives and organizes input from the body and the environment. SI therapy was developed based on the belief that some individuals with disabilities experience dysfunction in their nervous systems capacity to organize sensory input and, as a result, their responses to sensory input are non-adaptive. SI therapy seeks to restructure the way the nervous system responds to input so the child can better make sense of the world around them and, consequently, increase their adaptive responses. SI therapy programs are highly individualized. However, generally the therapy is focused on correcting deficits in the proprioceptive (muscles and joints), vestibular (gravity) or tactile (touch) sensory systems. Activities used to address these deficits include the use of weighted vests or blankets, swings, jumping on trampolines and deep brushing.
http://www.autism.org/temple/visual.html
Social Communication Emotional Regulation Transactional Supports (SCERTS)
Early identification and intervention that targets children who are developmentally from 8 months to 10 years of age. Multidisciplinary team collaboration, ongoing staff training, professional development, and administrative support. Adherence to all components of the SCERTS model with a sequential, logical procession from assessment to educational programming and less complex to more complex goals. Child-and family-centered approach with emphasis on family involvement and support. Transactional Supports should be implemented in a variety of settings (home, school, and community) to address Social Communication and Emotional Regulation objectives and promote generalization of learning within natural contexts. Promotes learning opportunities in inclusive settings. Promotes learning opportunities in inclusive setting. Supports low child to adult ration (2:1 for many or most children with ASD).
http://www.scerts.com/
Facilitated Communication
Facilitated Communication (FC) is an augmentative communication method that uses a facilitator as a physical support to aide the child in communication through pointing, writing or typing. The facilitator helps the child to isolate the index finger and to stabilize the hand, wrist, forearm or arm during typing. The facilitator also helps the child maintain focus on the process by encouraging the child to remain on task and redirecting the child back to task.
AUTISM SPECTRUM DISORDER WORKGROUP
CLASSIFICATION OF INTERVENTIONS FOR YOUNG CHILDREN WITH AUTISM SPECTRUM DISORDER *
January 2007
Provided by Dr. Richard Solomon (P.L.A.Y. Project)
Early Intensive Behavioral Intervention (EIBI)
Comprehensive behavioral programming that aims to improve socially important behavior by using interventions that are based upon principles of learning theory (i.e., Applied Behavior Analysis) and that have been evaluated in experiments using reliable and objective measurement. EIBI methods are intended to increase behaviors (e.g. on-task behaviors, social interactions) teach new skills (e.g., life skills, communication skills, or social skills), maintain existing behaviors, generalize or transfer behavior across situations or responses, and to restrict or narrow conditions under which interfering behaviors occur and reduce interfering behaviors. (e.g., self injury or stereotypy). Individual curricula and teaching approaches may vary but commonly used approaches include the UCLA model (Discrete Trial Training, Applied Behavior Analysis) and Applied Verbal Behavior (VB).
http://www.behavior.org/autism/index.cfm?page=http%3A//
http://www.cofeat.org/data/201/documents/ParentsPacket2005January.pdf
Learning experiences: An Alternative Program for Preschoolers and Parents (LEAP)
LEAP was originally established as a federal demonstration program in 1982 at the University of Colorado School of Education. LEAP includes a Preschool component and a behavioral skill-training program for parents. The Preschool curriculum provides opportunities for learning related to social, emotional, language, adaptive behavior, cognitive, and physical development. The preschool setting includes typically developing children and peers with autism. This program has been shown to be effective for students with and without disabilities. The research suggests that this program produces improvements in social and language skills.
Pivotal Response Training (PRT)
PRT is a behavioral treatment intervention based on the principles of applied behavior analysis (ABA). Researchers have identified two pivotal behaviors that affect a wide range of behaviors in children with autism: motivation and responsivity to multiple cues. These behaviors are central to a wide area of functioning, so positive changes in these behaviors should have widespread effects on other behaviors. Thus PRT is able to increase the generalization of new skills while increasing the motivation of children to perform. PRT works to increase attempts and interspersing maintenance tasks. PRT has been used to target language skills, play skills and social behaviors in children with autism.
http://psy.ucsd.edu/autism/prttraining.html
http://www.dbpeds.org/articles/index.cfm
Positive Behavior Supports (PBS)
Positive behavior support (PBS) is the application of behavior analysis in the assessment and reengineering of environments so people with challenging behaviors: Experience reductions in their problem behaviors; learn how to replace inappropriate behaviors with acceptable appropriate behaviors; and increase social, personal, and professional qualities in their lives.
PBS emphasizes the development and implementation of individually tailored support plans that focus on proactive and educative approaches.
The PBS process involves engineering the environment to prevent problems from occurring; teaching individually acceptable alternative behaviors to replace problem behaviors; and consistently providing for positive consequences that encourage appropriate behavior outcomes over time.
Pyramid Approach: includes using Picture Exchange Communication System (PECS)
One of the methods used under an ABA approach, PECS uses pictures and other symbols to develop a functional communication system. PECS teaches students to exchange a picture of a desired item for the actual items (e.g., requisting). The application of ABA methods to teach PECS is an appropriate intervention for children with ASD who have limited or no communication skills. To increase the utility of this intervention, an important area for future research is to investigate PECS procedures for promoting initiation of communication and acquisition of complex, flexible language.
http://www.pecs.com/
Hanen Program/More Than Words
Integrates more traditional behavioral approaches with developmental, social-pragmatic approaches into a single program.
Does not replace the need for an intensive intervention program, rather it provides parents with practical tools for facilitating social and communication skills in their young child with ASD; parent training is considered an effective practice for early intervention.
Parents are extensively involved in their child’s intervention program, which can be more appropriate and effective, and less expensive than direct speech/language therapy for very young children.
Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH)
The foundation of this structured teaching intervention is the modification of the environment to assist the child in the learning process. The focus of this intervention is on organizing the child’s physical environment to facilitate overall task success, capitalizing on visual strengths typically displayed by students with ASD and minimizing reliance on auditory processing/verbal expression. Visual schedules are used to describe sequence of activities, work systems are used to teach students to work independently and task organization provides information regarding how to perform task.
http://www.teacch.com/
Denver Model
Denver Model is a developmentally oriented approach for preschool age children. Focus of intervention is on intensive teaching and developing social-communicative skills. Provided in home setting, inclusive preschool programs & in one-to-one direct instruction. The skills to be targeted are determined by the family in collaboration with the intervention team.
Developmental, Individual difference, Relationship based (DIR) Including Floortime, Play Project & Responsive Teaching
Social Pragmatic Interventions (SPI). Focus on reciprocal, contingent interactions. Play-based, child led and structured by developmental level of child.
Well-structured parent training approaches. Manual includes extensive training materials.
P.L.A.Y. Project
http://www.playproject.org/
ECO/Communication Partners
Emphasizes importance of parent education and involvement – parent child interactions are viewed as the primary opportunity for teaching young children to talk.
Aims to prevent speech and language delays by treating infants and preverbal children to ensure healthy development of socialization and communication.
Focuses on social-pragmatic language skills rather than simply building the size of the child’s vocabulary.
Targets children who are considered to be at high risk for speech and language problems.
http://jamesdmacdonald.org/Articles/MacDonaldStart.html
Gentle Teaching
Gentle Teaching is a philosophical approach that addresses how caregivers interact with individuals with disabilities. This approach can be used with persons of all ages and with various disabilities. The focus of Gentle Teaching is to create a bond between the person with a disability and their caregiver as a means to promote positive changes. This method is opposed to the use of punishment and physical restraint.
http://www.gentleteaching.nl/
Music Therapy
Refers to the application of music with the intent to enhance functioning. It consists of using music therapeutically to address behavioral, social, psychological, communicative, physical, sensory-motor, and/or cognitive functioning. The music therapist involves clients in sensing, listening, moving, playing instruments, and creative activities in a systematic, prescribed manner to influence change in targeted responses or behaviors and help clients meet individual goals and objectives. Musical activities may also be highly preferred for an individual with autism (e.g., listening to music, dancing, playing an instrument). Access to such activities may be used as a reward; this is different from music therapy, in which the musical activities themselves are viewed as therapeutic.
http://www.musictherapy.org/
http://www.autism.org/music.html
Prompt
Seeks to understand sensory-motor systems and how these systems function in typical and delayed/disordered child development.
PROMPT therapists do not use oral-motor exercises, speech drills, or traditional speech development hierarchy.
PROMPT therapists do utilize tactile-kinesthetic information to improve motor control, and facilitate the development of functional cognitive, social, and communication skills.
PROMPT provides treatment individualized to each person’s specific needs.
http://www.promptinstitute.com/
Relationship Development Intervention
Relationship Development Intervention is an ongoing program of clinical development and research begun in 1996. The primary goal of RDI is to remediate the recognized core deficits of ASD. RDI provides individuals with ASD the cognitive, emotional, communicative and social tools that are geared towards remediation rather than compensation. Recognized deficits of individuals with ASD include emotional referencing, social co-regulation, experienced based communication, autobiographical or episodic memory, executive functioning and dynamic thinking. RDI is a family centered treatment program that prepares parents to act as ‘participant guides’, creating daily opportunities to remediate the developmental deficits of ASD. The provider undergoes an eighteen month internship in the program in order to become certified.
http://www.rdiconnect.com/
Sensory Integration (SI) Therapy
SI refers to how an individual’s nervous system, including the five senses of pain, vision, taste, smell and hearing, receives and organizes input from the body and the environment. SI therapy was developed based on the belief that some individuals with disabilities experience dysfunction in their nervous systems capacity to organize sensory input and, as a result, their responses to sensory input are non-adaptive. SI therapy seeks to restructure the way the nervous system responds to input so the child can better make sense of the world around them and, consequently, increase their adaptive responses. SI therapy programs are highly individualized. However, generally the therapy is focused on correcting deficits in the proprioceptive (muscles and joints), vestibular (gravity) or tactile (touch) sensory systems. Activities used to address these deficits include the use of weighted vests or blankets, swings, jumping on trampolines and deep brushing.
http://www.autism.org/temple/visual.html
Social Communication Emotional Regulation Transactional Supports (SCERTS)
Early identification and intervention that targets children who are developmentally from 8 months to 10 years of age. Multidisciplinary team collaboration, ongoing staff training, professional development, and administrative support. Adherence to all components of the SCERTS model with a sequential, logical procession from assessment to educational programming and less complex to more complex goals. Child-and family-centered approach with emphasis on family involvement and support. Transactional Supports should be implemented in a variety of settings (home, school, and community) to address Social Communication and Emotional Regulation objectives and promote generalization of learning within natural contexts. Promotes learning opportunities in inclusive settings. Promotes learning opportunities in inclusive setting. Supports low child to adult ration (2:1 for many or most children with ASD).
http://www.scerts.com/
Facilitated Communication
Facilitated Communication (FC) is an augmentative communication method that uses a facilitator as a physical support to aide the child in communication through pointing, writing or typing. The facilitator helps the child to isolate the index finger and to stabilize the hand, wrist, forearm or arm during typing. The facilitator also helps the child maintain focus on the process by encouraging the child to remain on task and redirecting the child back to task.
Monday, June 9, 2008
Parsimony
One of the four assumptions of science is that it is parsimonious. Therapeutic plans should also be parsimonious.
The purpose of the information found throughout this site is to help you keep not only the measurable behavioral objective but the entire plan as simple, clear, concise and parsimonious as possible.
In other words and as much as possible, Keep it Simple!
The purpose of the information found throughout this site is to help you keep not only the measurable behavioral objective but the entire plan as simple, clear, concise and parsimonious as possible.
In other words and as much as possible, Keep it Simple!
Monday, June 2, 2008
Shaping Compliance
Therapist often turn in plans that focus on getting a person to be compliant. I must confess that this idea is also not mine but makes perfect sense. Instead of working so hard to get someone to do something that s/he does not want to do, try getting them to do something that they do want to do. After a while, start throwing in something here and there that they may not be as motivated to do, always going back to including things that they do want to do. Over time you can include requests that are increasingly objectionable or difficult, continuing to include reinforcement. Before long they may be much more compliant in all appropriate areas.
Remember:
Almost no one is compliant 100% of the time, (and we worry a little about those who are). [For example, if you are working with a kid with special needs in a classroom and it is almost the end of the day or perhaps even the end of the school year and the rest of the class is off task, why in the world would you be trying to make the kid with special needs stay on task?]
&
If you are trying to get a kid to do something, make sure that it is within his or her capabilities. [Sometimes we even see plans trying to get a kid to do something that a typical kid of the same age would be unlikely to do, especially on their own and without help.]
&
Make sure you ask a child/kid to do easy and or preferred activities at least some of the time and on a regular basis. Even as adults, most of us don’t want to do something hard or unpleasant all the time. It’s good to learn and to stretch but not all the time. [You don’t ever want to be seen by the child as that person who only wants me to do things that are either extremely difficult or unpleasant all the time.]
Click here to continue with this information: Parsimony
Remember:
Almost no one is compliant 100% of the time, (and we worry a little about those who are). [For example, if you are working with a kid with special needs in a classroom and it is almost the end of the day or perhaps even the end of the school year and the rest of the class is off task, why in the world would you be trying to make the kid with special needs stay on task?]
&
If you are trying to get a kid to do something, make sure that it is within his or her capabilities. [Sometimes we even see plans trying to get a kid to do something that a typical kid of the same age would be unlikely to do, especially on their own and without help.]
&
Make sure you ask a child/kid to do easy and or preferred activities at least some of the time and on a regular basis. Even as adults, most of us don’t want to do something hard or unpleasant all the time. It’s good to learn and to stretch but not all the time. [You don’t ever want to be seen by the child as that person who only wants me to do things that are either extremely difficult or unpleasant all the time.]
Click here to continue with this information: Parsimony
The DEAD MAN (or WOMAN) test
Recently I attended a training/meeting where the DEAD Man test was mentioned. It’s the same concept as I have written about previously under the heading, “nature abhors a vacuum.” The concept here, though the same as previously discussed, is presented in a very different way and may strike a chord of understanding for some.
This is the idea. If your objective is to begin or increase a behavior that a “dead man or woman” could do, then you probably have a poor or even dead objective.
For example: Any time that your objective is that someone NOT do something, then that is something a dead man could do and is almost always a very poor objective.
There are some exceptions to this rule. There may be a time that you need someone to sit quietly for a brief period. Well a dead man could do that but it still may be appropriate.
Click here to continue with this information: Shaping Compliance
This is the idea. If your objective is to begin or increase a behavior that a “dead man or woman” could do, then you probably have a poor or even dead objective.
For example: Any time that your objective is that someone NOT do something, then that is something a dead man could do and is almost always a very poor objective.
There are some exceptions to this rule. There may be a time that you need someone to sit quietly for a brief period. Well a dead man could do that but it still may be appropriate.
Click here to continue with this information: Shaping Compliance
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