POSITIVE BEHAVIOR SUPPORT

by Barry K. Morris B.ScWk

Positive Behavior Support (PBS) is a behavioral intervention gaining in popularity for use with Autism Spectrum Disorders for resolving behavior problems. Children are supported in adopting socially meaningful behaviors, avoiding inappropriate behaviors, and learning functional skills as a replacement for problem behavior. It is based on principles regarding the rights of all children to be treated with dignity and have access to educational opportunities.

Principles of Positive Behavior Support

PBS implies an understanding that people (including parents) do not control others, but seek to support others in their own behavior change processes. There is a reason behind most inappropriate behavior of difficulty in acquiring skills, so the child should always be treated with respect. There should always be a focus on humane changes in the child's life to learn better behavior, instead of using coercion or punishment to manage behavior.

Positive Behavior Support involves a commitment to continually search for new ways to minimize coercion. This does not mean that parents should be judged too harshly if they occasionally resort to yelling. We can tend to fall back on patterns of care giving that have worked for us in the past, especially when we are challenged by difficult behavior. PBS (in this case) means that we have recognized when we have resorted to coercion, and continually seek to find alternatives that we can use next time challenges occur.

Functional Behavioral Assessment

This is a process for describing behavior, including environmental factors and setting events that predict the behavior, and guiding the development of effective and efficient support plans. Assessment lays the foundation of PBS. The assessment includes:

• a description of the problem behavior
• identification of events, times and situations predictive of problem behavior
• identification of consequences that maintain behavior
• identification of the motivating function of behavior
• collection of direct observational data.

The results of the assessment help in developing the individualized behavior support plan. This outlines procedures for teaching alternatives to the behavior problems, and alterations to the circumstances most associated with the problems.

Identify strengths and needs

What skills does the child have? For example a student who cannot sit still in class may be a great help to working on the stage crew for a production. It is important to establish the child's level of insight, reasoning skills and capacity to control their behavior.

What does the child enjoy and hate? This can help to establish positive and negative reinforcements of behaviors. Other points to be included for consideration are, values/culture, biomedical/physical factors, environmental factors, motivation, intervention history, learning history, learning style, and relationships.

CHOOSING A BEHAVIORAL STRATEGY

There are many different behavioral strategies to encourage individuals to change their behavior. Some of the most commonly used approaches are:

• Modifying the environment or routine

• Tactical ignoring of the behavior

• Distracting the child
• Positive reinforcement for an appropriate behavior
• Changing expectations and demands placed upon the child
• Teaching the child new skills and behaviors

• Modification techniques such as desensitization and graded extinction
• Changing how people around the child react
• Time out
• Medication.

behavior management program

The key questions in developing a behavior management program include:
• What are the specific behaviors to address?
• What is the current pattern of behavior?
• What is the goal for change?
• What are the steps towards achieving the goal?
• How will change be recognized and monitored?
• What approach or combination of approaches is most likely to be effective?

For all carers and family members involved in the program, a consistent approach is often the most significant factor influencing success. The expectations of behavioral change also need to be clearly defined and realistic. It may not be possible to change all behaviors at once, or in all situations.

Consequential management

Consequential management is a positive response to challenging behavior It serves to give the person informed choice. It gives the person an opportunity to learn. Consequences exist within our society, and we live with the consequences of our actions on a daily basis. For example, if we speed and are caught, the consequence is more than likely to be that we will get a speeding ticket. The use of consequential management is a positive response to behavior, it allows a person informed choice and an opportunity for learning.

Consequences must be clearly related to the challenging behavior. For example, if a glass of water was thrown and the glass smashed, the logical consequence would be for the person to clean up the mess and replace the glass. If an unrelated punishment was enforced, such as not being able to go to the movies the next day, the person would not be able to see or understand the link and the learning benefits of the process would be lost.

Providing choices is very important and staff can set limits by giving alternatives that are related to a behavior they are seeking. It is important that the alternative is stated in a positive way and that words are used which convey that the person has a choice. For example:

Not so good way
“If you don't cut that out you'll have to leave the room.”

Better way

“You can watch TV quietly or leave the room.”

Managing Crisis Situations

When behavior becomes violent towards others or self-injurious, what options do we have to help the individual whilst also protecting the rights of others? Should the person be removed and if so how? Where should he go and for how long? Should he be left alone or supervised? What are the expectations of the individual and the caregivers during this period of removal? Whatever action is taken it should be calm, unemotional and not use excessive force.

Dealing with others' expectations

Often parents’ reactions to crises are more influenced by the ‘spectators’ than they are by the most effective way to deal with the behavior. Outside observers are often quick to make judgments such as ‘what a tantrum' or 'spoilt brat!’ and those judgments do affect how a challenging situation is responded to. Parents need tools to deal with the expectations of others, whether real or perceived, if they are to be effective in helping their child to gain control of their behavior.

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