When addressing behavior problems, a careful assessment provides the foundation for effective and efficient intervention. Consider the following scenario: After struggling with headaches for nearly a week, you visit a doctor. Following a brief discussion, the doctor suggests brain surgery. While surgery may be effective, it is also possible that your headaches are related to the fact that the prescription in your glasses is out of date. Or, they may be caused by not drinking enough fluids on a daily basis.
You would not want to undergo an eye exam if the headaches could be alleviated by drinking more water. And you would not want to undergo surgery, if the headaches could be treated by purchasing updated lenses. While there are multiple treatment options for headaches, the quickest and most effective way to alleviate them is to precisely identify the cause.
Similarly, effective management of challenging behaviors in children, such as tantrums and non-compliance, must begin with a careful, detail-oriented assessment.
Conducting an Functional Behavior Assessment and Developing a Behavior Intervention Plan
The most effective way to understand and manage these behaviors is to conduct a Functional Behavior Assessment (FBA) and develop a Behavior Intervention Plan (BIP). The New Jersey Special Education Code (Chapter 6A:14) requires school personnel to complete an FBA and BIP when a student displays behaviors that significantly interfere with daily functioning.
An FBA refers to the full range of procedures to identify a specific problem behavior, to understand the factors leading up to and following it, and to generate hypotheses about the reasons the problem behavior maybe occurring. A BIP refers to strategies designed to reduce the problem behaviors and increase desired behaviors.
It helps to think of an FBA/BIP as a five step model:
Step 1: Precisely define the problem behavior – Behaviors should be identified and described in terms that are specific, observable, and measurable. For example, “calling out” may be defined as “a student speaking during a class discussion without raising his hand and being called on to speak.” It would be insufficient to say the child is “impulsive” since that can occur in many different ways. A “tantrum” may be defined as a child “saying ‘no,’ yelling, and flailing his/her body onto the floor.” This is contrasted with labeling the child as having “anger management problems,” which is vague. As a rule of thumb, a behavior is sufficiently defined when two objective observers could independently spot it based on the definition provided.
Step 2: Measurement – The purpose of measurement is to determine the frequency, intensity, and duration of a target behavior. For example, “calling out” may occur 3 times in a day or 10 times in a 45-minute class period. Tantrums may occur only twice a day, but may last 60 minutes each and present with strong intensity. The measurement stage provides baseline data. After an intervention is conducted, follow-up data can help determine whether the intervention is effective and can be used to make adjustments to the plan. Although data collection may seem tedious, the rationale is the same used by a physician prescribing medication for cholesterol – assessing initial and follow-up levels ensures that the intervention is working.
Step 3: Functional assessment – The goal of a functional assessment is to better understand the child’s reason for, or function of, the specified behavior. Behavior typically occurs for a reason – gaining attention from adults or peers; escaping or avoiding a demand or request; gaining access to something preferred (or tangible); and trying to obtain or avoid something that is internally or automatically reinforcing (e.g., increasing time listening to pleasant music, decreasing painful headache). Hypotheses about functions are determined based on the data collected about what occurs directly before and after a child exhibits the target behavior, and are often the key to successful intervention. For example, if the function of a child’s “calling out” behavior is to gain the teacher’s attention, then the teacher’s verbal reprimand may be increasing the likelihood of it occurring again. If a child’s tantrum behavior serves the function of avoiding a task, sending him to time-out may be giving him exactly what he wants. Thus, indentifying the function of a child’s behavior is critical in order to develop an effective intervention and minimize the possibility of responding to the problem behavior in ways that will actually keep it going.
Step 4: Developing the plan – Writing a BIP involves identifying behaviors you would like to see more of (i.e. replacement behaviors) and selecting strategies to facilitate the development of these behaviors. Replacement behaviors can include specific skills, such as social skills or functional communication. In the case of the student calling out in class, a replacement behavior might be for the student to raise his hand and wait to be called on before speaking. In the example of tantrum behavior, replacement behaviors may be verbally expressing emotions in an appropriate way, engaging in an alternative coping strategy to manage anger (such as taking deep breaths) and/or complying with the instructions (e.g., making the bed, doing homework, doing classwork). It is critical for parents and school personnel to help children practice replacement behaviors and reinforce them with praise, as well as to consider additional forms of reinforcement, such as prizes or privileges.
Step 5: Evaluate – The evaluation phase involves taking an honest look at whether the procedures are being implemented as designed, reviewing data to determine whether there is a reduction in the problem behavior and an increase in desired replacement behaviors, and making modification to the plan as needed. For example, regarding the “calling out” behavior, we want to see whether the teacher has actually been ignoring the calling out behavior and praising the student for raising his hand, as well as analyzing the data to determine whether this has resulted in an actual decrease in calling out. In the case of the tantrum behavior, we may want to confirm that the child has been practicing his coping skills training and that the specific procedures outlined to occur when the tantrum behavior or use of a desired replacement behavior occurs is actually being carried out as planned.
This 5-step process of conducting an FBA and developing a BIP can be time consuming. Yet, a thoughtful assessment and plan developed by parents and/or school personnel provides the greatest opportunity to achieve behavioral success.
Keys to Putting a BIP into Practice
Conduct a Meeting after the FBA is completed – Set up a convenient time to meet with members of the IEP team, including school personnel, parents, and private professionals who are working with the identified child. If any IEP team members are unable to attend in person, consider having them join by phone or video conference. At the meeting, discuss the results of the FBA in detail. Present definitions of the target behaviors, explain the rationale for the method of data collection that was used, share the results, and discuss the hypothesized functions of behavior. Reviewing the FBA helps ensure that all the participants at the meeting recognize the scope and nature of the problem behaviors. Discussing the FBA provides the foundation for a more meaningful discussion about interventions.
Before closing the meeting, make a plan for monitoring progress. Is the intervention being implemented as prescribed? Are data being collected and graphed? Are there any changes that need to be made? Are the caregivers being updated? These are all important components of a successful plan.
Incorporate antecedent-based interventions – Antecedent-based interventions are critical, yet commonly overlooked. Antecedent interventions refer to strategies that help to prevent the problem behavior from occurring. In other words, they are proactive, rather than reactive. Be sure that antecedent strategies are included in the BIP. Consider a student who is engaged in the problem behavior of flopping out of his chair after completing five math problems. Antecedent-based suggestions may include modifying the instructional task for the student and/or allowing the student access to a preferred task after completing three math problems.
Identify replacement behaviors – Recommendations to address replacement behaviors should always be included in the BIP and reviewed with the team. Replacement behaviors refer to the set of appropriate behaviors which serve the same function of the problem behavior. For example, if a student runs away or yells “NO” when an instructional task is presented or a demand is made, it may be hypothesized that the function of the student’s behavior is to avoid or escape the instructional task or the demand. If the avoidance behavior is the result of the task or demand being too difficult, replacement behaviors may be to teach the child to calmly ask for help. Alternatively, he may be taught to hold up a picture card to request a break, utilize a “break pass,” or hand the teacher a card that says “one minute please.”
Obtain “Buy-In” – Obtain “buy-in” from all of the team members. First, be sure to clearly explain suggested strategies for intervention, as well the empirical research to support the suggestions. Simply forwarding the FBA/BIP with a note, “Here it is, it is all in the report,” will often lead to frustration. Second, be sure that all team members understand the rationale for the strategies that are suggested. If there is clarity about the reason for procedures, school staff and parents are more likely to implement them. For example, for the antecedent-based recommendation of modifying a task, it may be helpful to explain that by reducing the response effort to attain a reward or teaching a functional replacement (e.g., saying “break please”), the student is more likely to change his behavior. Third, solicit feedback about the plan. Questions to consider posing to the team include the following: what do you think about the plan, does the plan make sense to you, how do you see yourself implementing these procedures, and what obstacles do you foresee? With school personnel and caregivers already stressed and pressed for time, it is important to strategize with them in a real and practical way about how the procedures will be implemented.
Train school personnel – Teaching educators and caregivers to implement procedures appropriately and correctly is important for the student’s success. Identify which staff requires training, plan when the trainings will take place, and identify who will provide the training. If no personnel at the school are able to provide the training, consideration should be given to bringing in an outside consultant. Training of educators and caregivers should consist of a proven, multi-component process that includes direct instruction, modeling, rehearsal/role play and corrective feedback (Stewart, Carr, and LeBlanc, 2007; Miles and Wilder, 2009). In the example of teaching a student how to request a break, modeling the procedure for the staff, role playing the procedure (i.e. taking turns being the teacher and student), and then providing feedback would help staff adhere to the procedure.
Keep it Simple – Whenever possible, try to keep the plan simple. Overly complicated procedures and data collection methods leads to confusion and may result in lack of adherence and non-compliance to the plan.
Dr. Meir Flancbaum is a licensed psychologist at Behavior Therapy Associates in Somerset, NJ. Ms. Elena Zaklis is a board certified behavior analyst at Behavior Therapy Associates. Dr. Michael Selbst is a licensed psychologist and Director at Behavior Therapy Associates. They provide a variety of services for children and adolescents with autism spectrum disorders and related disorders, including individual and group therapy, school-based consultation, functional behavior assessment and behavior intervention planning, and training workshops for professionals and parents. For more information about Dr. Flancbaum, Ms. Zaklis, and services provided at Behavior Therapy Associates, visit www.BehaviorTherapyAssociates.com. Correspondence can be directed to mflancbaum@BehaviorTherapyAssociates.com.
References
Stewart, K. K., Carr, J. E. & LeBlanc, L. A. Evaluation of Family – Implemented Behavioral Skills Training for Teaching Social Skills to a Child with Asperger’s Disorder. (2007). Sage Publications, 6, 252-262.
Miles, N. I. & Wilder, D. A. (2009). The Effects of Behavioral Skills Training on Caregiver Implementation of Guided Compliance. Journal of Applied Behavior Analysis, 42, 405-410.
