Navigate Life Texas: Resources for kids with disabilities and special needs

Navigate Life Texas: Resources for kids with disabilities and special needs

Using and Understanding Positive Behavioral Support

06/10/2015 | Published by: Michael Tucker

Parents often experience occasional problem behavior from their children – that’s just a part of growing up. Sometimes, however, problem behavior can become more frequent or significant in its impact, such as when it starts to get in the way of a child’s opportunities to learn or take part in community life, or when it affects the child’s or family’s quality of life. When this happens, families might benefit from getting help from someone with knowledge and skills around behavior change –positive behavior support in particular.

Understanding Positive Behavior Support

Positive behavior support (PBS), also referred to as positive behavioral interventions and supports (PBIS), is an approach to preventing and changing problem behavior that is based on behavioral science and a person-centered approach.

It emphasizes:

  • Improving a child’s quality of life.
  • Changing the child’s environment.
  • Teaching the child new skills.

All of this is done with two approaches: supporting positive behavior and making the problem behavior unnecessary.

PBS is different from older, more reactive behavioral approaches that punished a child for problem behavior. Instead, it focuses on preventing problem behavior and using strategies that increase positive behavior. This difference is especially important for children who have disabilities. Often children with disabilities have limited skills that make it more difficult to get the things that they want or need; this often contributes to problem behavior.

Understanding the Purpose of Behavior

The first step in the PBS approach is to understand why a child is engaging in (doing) a problem behavior. This is critically important because different people may use similar behaviors for entirely different reasons, and the same person may use the same behavior for different reasons under different circumstances. While the assessment (called a functional behavior assessment) to figure this out is usually done by someone with PBS skills and knowledge, parents can often get a pretty good idea about the purpose of a behavior by writing down what happened right before the behavior and what happened right after.

Using this information, parents can try to figure out the broad purpose (or function) of the behavior:

  • Does the child want to get something? An item, activity, attention, or stimulation?
  • Does the child want to avoid something? To escape or get a break from a particular task, avoid attention, or decrease stimulation?

Understanding the first part – the conditions that make the problem behavior more likely – will lead to ideas about how to change the setting to prevent challenging behavior. Understanding the second part—the purpose or function of the behavior—will lead to ideas on what strategies to teach the child (and parent) to make the problem behavior unnecessary.

Sarah’s Story

Take the case of Sarah, a lovely 7-year-old child with Down syndrome. Sarah only has about 20 words in her vocabulary at this age, and often seems frustrated when people don’t understand what she wants. While her parents sometimes saw problem behavior from Sarah when she was younger, it was a lot like what they had experienced with her siblings who did not have disabilities. More recently, however, Sarah started hitting and scratching her mother, father, and teacher at school. There were also incidents where Sarah started crying and hitting herself in the head.

Finding the Purpose of Sarah’s Behavior

With behavioral support from someone who knows about PBS, Sarah’s parents started writing down the conditions or events that happened right before and right after the problem behaviors. After a week or 2, they could see some fairly clear patterns.

  • Sarah was most likely to hit and scratch when she was asked to do a task she did not like (such as brushing her teeth, taking a shower, and some academic tasks at school). Hitting and scratching often led to at least a temporary break from that activity. So, it appeared that Sarah was more likely to hit and scratch in an effort to delay or escape a task she didn’t like.
  • Sarah seemed to cry and hit herself in the head mostly after trying to interact with her parents when they were in the middle of something like cooking dinner. Sarah’s parents noticed that once she started crying and hitting herself in the head, they would immediately stop what they were doing and ask her what she wanted. It seemed likely that when Sarah couldn’t get the attention she wanted from her parents, she engaged in crying and hitting herself in the head to get their attention.

Creating Strategies for Sarah

Armed with this information, Sarah’s parents were ready to develop strategies to better support their daughter. They wrote down the things they thought were important to Sarah, like having special time with them in the early evening after school and playing with friends, and they came up with strategies for her to do those things more often. A particular problem time was when she wanted attention but the only parent at home was cooking dinner, so her parents decided to try to let her help during meal preparation. Sarah seemed to love this because, not only did it give her something important to do, but she also could do it while spending time with a parent.

Sarah’s parents then thought about the other facts they had gathered about Sarah’s problem behavior and came up with some more strategies to help her. Because the scratching and hitting were more likely to happen during tasks that Sarah did not like, they used three strategies:

  • They started letting Sarah decide when she would brush her teeth during morning and bedtime routines and what time she would shower at night. Simply allowing her to choose was helpful.
  • As soon as Sarah completed a task she didn’t like, they made sure that Sarah got to do something she really liked (watch her favorite TV show in the morning before school, bedtime stories at night).
  • They also realized that Sarah did not really know how to delay a task appropriately, so they worked with her schoolteacher to teach her how to say and sign for a break. Now, when Sarah asks for a break, both her parents and the teacher say, “Sure, you can have a break,” and then set a timer for 1 minute. Most of the time, Sarah immediately re-engages in the task when the timer sounds.

Because she tended to cry and hit herself in the head during times when she was not getting a lot of attention, Sarah’s parents started looking for opportunities to reinforce more desirable behavior with attention and praise. Helping in the kitchen almost got rid of this problem behavior entirely during mealtime preparation, but Sarah’s parents knew that there were other times when they would be busy with something and they wouldn’t be able to include her. In order to prevent the problem behavior during these times, they used these strategies:

  • They started introducing an activity that Sarah really liked to do by herself (looking through magazines and cutting out pictures) right before they needed to start their task.
  • They realized that Sarah did not have very many ways to let people know she wanted attention. So, they decided to teach her how to say, “Can we play?” to show that she wanted to spend time with someone. They started reinforcing her use of this phrase with instant praise and attention.

With these strategies in place, Sarah’s problem behavior happened much less often, and everyone in the family seemed happier. And, with the behavioral problem-solving knowledge and skill the parents gained from this experience, they are better prepared for any future issues Sarah might face.

For more parent-friendly information on PBS, visit the “For Families” link at the website for The Center on the Social and Emotional Foundations for Early Learning, or read the book Parenting with Positive Behavior Support: A Practical Guide to Resolving Your Child’s Difficult Behavior by Meme Hieneman, Karen Childs, and Jane Sergay.

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