positive behaviour support

Question 1

what is PBS?

Answer 1

Positive behaviour support is the application of the science of Applied behaviour analysis in support of people with challenging behaviour.
it starts with an assessment which is an attempt to understand the meaning of the challenging behaviour from the clients’ point of view.

Question 2

what kind of approach does PBS adopt?

Answer 2

PBS does not just use a linear approach that focuses on the three term contingency of: antecedent-behaviour-consequence.
PBS is nonlinear, they include adaptations the environment based on a comprehensive understanding of the impairments and support needs of the individual.

Question 3

what do the non-linear supports include?

Answer 3

• They involve teaching skills to replace the aggressive behaviour.
• They include focused support strategies to achieve rapid reductions in their frequency of behaviour, such as the antecedent control i.e. removing or reducing behavioural triggers and schedules of reinforcement.
• They include reactive strategies designed to reduce the episodic severity of behaviour.

Question 4

why should a constructive behavioural perspective?

Answer 4

the range of support strategies increases when one adopts a behavioural constructional prospective.
- a constructional prospective seeks to identify a new behaviour that could replace the target behaviour and achieve the same functions for the person.

Question 5

when will a new behaviour be selected?

Answer 5

A new behaviour will be selected if it elicits more valuable reinforcement, more reliable reinforcement or more needed reinforcement, or if it requires less effort (either cognitively or physically) than the target behaviour.

Question 6

what is one of the central messages of PBS?

Answer 6

one of the central messages of PBS is that the focus should be on fixing the context in which behaviours occur rather than fixing problems behaviours themselves.

Question 7

what was found in Carr’s article on motivations for self-injurious behaviour?

Answer 7

Carr’s article on the motivations for self-injurious behaviour, which were translated into experimental observation conditions by Iwata, can be understood as an indictment of the environments into which people with challenging behaviours are placed.
…environments in which attention is difficult to attain, or in which activities are so aversive or meaningless that escaping from them is worth injuring oneself.

Question 8

what is the link between contexts and behaviour?

Answer 8

every behaviour occurs in multiple contexts.
each context adds a layer of depth to the meaning of the behaviour.
many of these contextual factors exert an indirect influence on behaviours

Question 9

what can ameliorating the impact of these contextual variables on the three term contingency model do?

Answer 9

Ameliorating the impact of these contextual variables on the three term contingency (of antecedent, problem behaviour and consequence) significantly increases the range of interventions available.

Question 10

what did Kincaid in 2002 specify?

Answer 10

Kincaid in 2002 specified a number of components of quality of life as the criteria for outcomes of PBS practices. these include:

• emotional well-being
• interpersonal well-being
• material well-being
• personal well-being
• physical well-being
• self-determination
• social inclusion
• rights

Question 11

what are the key features of PBS in summary?

Answer 11

1) Functional assessment of behaviour:
the function is understood not simply in terms of the reinforcer it elicits, but also in terms of the support needs of the person and the contextual variables that influence the frequency and episodic severity of the behaviour.
2) Multi-element behaviour support plans:
these seek to prevent behaviour through environmental changes, skills teaching and contingency management and to respond to behaviour so as to reduce episodic severity.
3) Life enhancing interventions: these remove barriers to community participation. Effective PBS often involves a reconstitution of the meaning of the client’s life, a reassessment of what is important to the client and a vision for a better future.

Question 12

what are the four main components of designing a behaviour support plan?

Answer 12

• environmental accommodations
• skills teaching
• direct interventions
• reactive strategies

Question 13

what constitutes environmental accommodations? (1)

Answer 13

• low arousal
• rapport
• picture sequencing
• activity sampling

Question 14

what is low arousal, as part of environmental accommodations?

Answer 14

Interventions are designed to reduce the effects of stress. Arousal can include removing, reducing or ameliorating the effect of antecedent stimuli, such as: demand noise, complexity of language, proximity refusal, disappointment and surprise.

Question 15

what is rapport, as part of environmental accommodations?

Answer 15

rapport interventions improve the quality of relationships between the client and those in their interpersonal environment.

Question 16

what is picture sequencing, as part of environmental accommodations?

Answer 16

picture sequencing interventions involve using carefully designed sequences of pictures to communicate to climb schedules of activity that will occur.
- visual activity schedules have been found to operate as antecedent interventions that limit the impact of setting events such as unpredictable translations and stressful activities.
- picture sequencing can be used to alert a person to upcoming changes in routine, as a means of negotiating the time of preferred activities and as a means of cueing a transition from one activity to another.
… an example of picture sequencing protocol is to rehearse the full sequence with the client first thing in the morning, early afternoon and late afternoon.. at the start of each activity remove the corresponding picture and give it to the client.. guide the client to the activity and prompt them to place the cards beside the activity.

Question 17

what is activity sampling, as part of environmental accommodations?

Answer 17

activity sampling involves brainstorming potentially enjoyable novel activities for clients, observing their responses to these and recording these responses.
- it is especially important when functional analysis suggests that behaviours are more likely to occur when the person is bored or under-stimulated.
… an example of activity sampling protocol: for each new activity record by the client’s initial reaction, how long the client participated, and their reaction to the cessation of the activity and a 1-5 rating of their enjoyment.

Question 18

designing a behaviour support plan, skill teaching: what is skills teaching involves error-free learning?

Answer 18

skills teaching involves error-free learning; this means using prompts to ensure correct performance.
teaching involves gradually and systemically fading the prompts until the client can complete more of the task independently.

Question 19

what is teaching is in context,m in relation to skills teaching?

Answer 19

where possible, skills are taught in the situations and conditions that best approximates those in which they will actually be used.

Question 20

what is physical prompts are easier to fade, in relation to skills teaching?

Answer 20

prompts can be faded from hand-over-hand to hand-over-wrist, hand-over-elbow and hand-over-shoulder.

Question 21

what is teaching is silent, in relation to skills teaching?

Answer 21

silent teaching reduces the demands and clients during skills acquisition.
- If the instructor speaks during the teaching style, then in order for the learner to process the information they need to switch attention of the task and transfer attention to the teacher.
- many learners can still learn while an instructor’s speaking, however for some learners who have difficulty switching attention may find the requirement to switch attention for visual to verbal and back to visual modalities excessive for them the process.
…may amount to a form of attentional gymnastics! lol

Question 22

what constitutes skills teaching? (2)

Answer 22

• skills teaching involves error-free learning
• teaching is in context
• physical prompts are easier to fade
• teaching is silent

Question 23

what else may a behaviour support plan include?

Answer 23

• another type of skills teaching typically included in a behaviour support plan involves teaching coping and tolerance skills:
• noise, disappointment, criticism, refusal, waiting transitions and non-preferred tasks frequently arise as events that people may be motivated to avoid.
• a behaviour support program may involve teaching a person is skills for coping with these events.

Question 24

what constitutes direct interventions? (3)

Answer 24

• antecedent control
• instructional control
• stimulus control
• differential reinforcement procedures

Question 25

what is the point of direct interventions?

Answer 25

the role of direct interventions is to bring about a rapid reduction in the rate or severity of the behaviour. ...over time the interventions are described as direct because they impact directly on the immediate antecedents or consequences of behaviour.

Question 26

what is antecedent control, in relation to direct interventions?

Answer 26

antecedent control involves removing, reducing or altering a stimulus that typically precedes the onset of problematic behaviour. it is based on the principle that in the presence of certain discriminative stimuli, behaviour is more likely to be reinforced and therefore more likely to occur.

Question 27

what are examples of antecedent control?

Answer 27

- suppose a self injurious behaviour is more likely to occur in response to request to move; antecedent control options include withdrawing requests to move, reducing the frequency of such requests or modifying the ways in which such requests are made. ...instead of saying "it's time to go to lunch", a carer might say, "would you like to come to lunch now or would you like to stay here?" (two-way choice format), or give the person a plate (object cue format). - when aggressive or self-injurious behaviours are dangerous, antecedent control is often the first choice of direct intervention.

Question 28

what is instructional control, in relation to direct interventions?

Answer 28

instructional control involves requesting a behaviour and rewarding the behaviour for occurring. the goal in teaching instructional control is to increase the frequency of request-response correspondence.

Question 29

what is stimulus satiation, in relation to direct interventions?

Answer 29

- Stimulus satiation involves the continuous application of the reinforcer that has been identified as meeting the target behaviour. - Stimulus satiation interventions are recommended with reinforcing maintaining to behaviour is attention. - like all direct interventions, Stimulus satiation is not a constructive intervention. Constructive interventions include teaching skills for relaxing, communicating or problem-solving.

Question 30

what are differential reinforcement procedures, in relation to direct interventions?

Answer 30

differential reinforcement procedures involve providing reinforcements for the non-occurrence or reduced occurrence of target behaviours, or for the occurrence of alternative behaviours that compete with target behaviours. - these interventions are indicated when the client has an alternative appropriate behaviour within their repertoire, and is not usually motivated to use the appropriate behaviour. - differential reinforcement procedures may also be used in combination with attempts to teach the person an alternative appropriate behaviour... Differential Reinforcement of Other behaviours/ DRO.

Question 31

what are the different types of differential reinforcements?

Answer 31

- differential reinforcement of incompatible behaviour (DRI), - differential reinforcement of alternative behaviour (DRA), - differential reinforcement of other behaviour (DRO), - differential reinforcement of low rates of responding (DRL)

Question 32

what is DRO?

Answer 32

differential reinforcement of other behaviour, DRO, delivers reinforcement for any appropriate behaviour whenever an undesirable behaviour is not emitted during a specific period of time

Question 33

what is DRI?

Answer 33

differential reinforcement of incompatible behaviour (DRI), delivers reinforcement upon the occurrence of a behaviour that is physically incompatible with or cannot be exhibited at the same time as the inappropriate behaviour.

Question 34

what is an example of DRI?

Answer 34

hair pulling: get their hands occupied with something else so they physically cannot pull hair. it will replace the challenging behaviour and it will also drive it down because it is incompatible. cannot engage in problem behaviour and replacement behaviour at the same time. reality is that it is hard to do outside of classroom setting.

Question 35

what is DRA?

Answer 35

Differential reinforcement of alternative behaviour (DRA) is similar to DRI in that both reinforce the occurrence of a behaviour that is an alternative to the behaviour selected for reduction (Deitz & Repp, 1983). However, the target behaviour selected in DRA is not necessarily incompatible with the unwanted behaviour. DRA weakens the problem behaviour while strengthening the acceptable behaviour, sometimes both behaviours occur at once!

Question 36

what are examples of DRA?

Answer 36

- a student who frequently engages in outbursts while in the classroom can be taught to raise his hand to gain the teacher's attention. In this procedure, hand-raising and outbursts can be done at the same time. However, it is likely that the student will make fewer outbursts and instead engage in a more appropriate attention-seeking behaviour (e.g., raise hand). - classroom setting where one child is annoying the child beside him; reinforce child when they’re doing work or putting up hand for question and not reinforce them picking on child.

Question 37

how can we use DRI/DRA effectively?

Answer 37

choose a behaviour in their repertoire that will require equal or less effort than the problem behaviour. name behaviour and reinforce them for it to make them aware what they’re doing wrong, kids with disability find it very hard to understand what you’re telling them, person doing behaviours can often not verbalise why they’re doing them. ...we do things at time and we don't know what the motivation for doing them in. reinforcers act in for an inability to specify why they’re doing something.

Question 38

what is DRL?

Answer 38

differential reinforcement of lower rates of a behaviour (DRL): kid who asks too many questions and you reinforce them, kind of intermittent reinforcement in a way and relates to a no of times behaviours occur and don’t reinforce it at every time, set a timer on them and only reinforce the kid three mins since they last asked a question, we don't get smiled at every time but we don’t give up smiling! this differential reinforcement type is related to timing of reinforcing a behaviour, however it’s time consuming which makes it difficult. it requires accuracy which is most difficult thing, don't want intervals to be too long so there needs to be frequent reinforcement.

Question 39

what are reactive strategies?

Answer 39

Reactive strategies in contrast proactive strategies with introduce the frequency of episodes of challenging behaviour of the primary purpose of reactive strategies to optimise the safety of all concerned by reducing the severity of episodes of challenging behaviour. ...at the heart of reactive planning is principle that the response to challenging behaviour should be matched to the level of severity of the behaviour.

Question 40

how can measure episodic severity of behaviour?

Answer 40

for example, an episode of self-harm might be measured on a five-point scale with: 1 = talk about self-harm 2= verbal threats to self-harm 3= physical evidence to support verbal threats to self harm, such as a collection of tablets or sharp implements 4= actual self-harm, requiring no more than first aid 5= self harm requiring medical attention.