Polk County PBS Academy

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Welcome!
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Polk County PBS Academy

• PBS 101

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Training Objectives

• To learn what PBS is as both philosophy and tools
• Learn the basics of how we set the tone for the
  environment-to help or hinder
• Learn basic tools of PBS
• Learn how to use data to drive decisions

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What is PBS

• It is a philosophy and a set of tools
• A way of thinking and doing
• Positive behavior support offers a proactive
  process for
• addressing behavioral challenges,
• teaching adaptive skills, and
• improving quality of life.

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Polk County PBS Mission Values

• We are an inter-agency coalition promoting
  positive support to enhance the quality of life
  for persons with disabilities.
• We make decisions based on
• Dignity respect
• Long-term commitment
• System consistency
• Person-centered
• Empowerment through training, support,
  education
• Reducing the need for right restrictions
• Promoting full citizenship and the exercise of
  choice

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Insert Agency MVV Slide

• Insert MVV Mission
• Vision
• Values

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Insert Agency PBS Policy
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Section One Philosophy
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How you see me!
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How I want to live!
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Universal Enhancement Strategies
Gardening
Dancing
Religion
Hiking
Pets
Sex
Music
Spontaneity
Work
Fishing
Day at the spa
Grilling out
Good Health
Dining out
Family
Vacationing
Volunteering
Exercising
Movies
Voting
Having a will
Friends
Things of Value
Positive rituals
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GEM

• Good Enough for Me
• Tom Pomerantz

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I have come to the frightening
conclusion that I am the decisive element in my
environment. It is my personal approach, which
creates the climate. My daily mood makes the
weather. I possess tremendous power to make a
persons life miserable or joyous. I can be a
tool of torture or an instrument of inspiration.
I can humiliate or humor, hurt or heal. In all
situations, it is MY response that decides
whether a crisis will be escalated or
de-escalated and a person humanized or
dehumanized. ( Adapted- Halm Ginott)
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Life
We must provide an environment that is healthy
enough for a life to happen.
Dan Berkowitz
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Effective Behavioral Support
..requires the design of an environment that
makes problem behaviors

Irrelevant
Ineffective
Inefficient
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Prove It!

• Prove that
• treating people with
• dignity and respect
• meeting unmet needs
• bonding
• decreases the frequency
• and intensity of
• challenging behavior.
• Does it Matter?!

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Respect Fundamental to PBS

• A personal quality that is non-contingent
  provided without judgment and given equally to
  all persons.
• People should not have to earn your respect they
  should be the recipient of your respect without
  condition.

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Defining Characteristics of PBS

• Person centered
• Collaborative on-going process
• Data-driven decision making
• Prevention, positive, proactive strategies
• Meaningful outcomes

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• IS NOT
• Simple
• Short term
• Just Decrease Behavior
• Reactive
• Aversive (punish)
• Observable Behavior
• Experts Decide

• IS
• Comprehensive
• Long term
• Teach Useful Skills
• Proactive
• Positive (reinforce)
• Function
• Involve Individual

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• If an individual doesnt know how to read, we
  teach.
• If an individual doesnt know how to swim, we
  teach.
• If an individual doesnt know how to multiply, we
  teach.
• If an individual doesnt know how to drive, we
  teach.
• If an individual doesnt know how to behave,
• weteach?.................punish?
• Why cant we finish the last sentence as
  automatically as we do the others?
• Tom Herner (NASDE President, Counterpoint 1998,
  p.2)

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Section 2 ToolsHow we get to a Life!
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Four Steps to Designing an Effective Behavior
Support Plan

• Step One
• Step Two
• Step Three
• Step Four

• Gather Information
• Develop a Hypothesis
• Build a Support Plan
• Evaluate effectiveness and modify support plan as
  needed

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Step 1 Gather Information

• Person Centered Planning

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Five Essential Goals of Person Centered Planning

• Expressing preferences and making choices in
  everyday life
• Gaining and maintaining satisfying relationships
• Having opportunities to fulfill respected roles
  and live in dignity
• Being present and participating in community life
• Continuing to grow

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Characteristics of Person-Centered Planning

• Includes focuses on the individual
• Respects the individual and their dreams and
  choices
• Emphasizes strengths, abilities, and capacities
• Strength based Training principles
• Individualized supports
• Empowers the consumer and team

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Tools for Person-centeredPlanning

• Insert organization planning tools

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What is behavior?

• Anything a person says or does
• 90 of behavior is communication
• Must be observable and measurable
• Must meet the dead mans test
• If a dead man can do it, its NOT behavior

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Behavior is method of communication both
verbally physically of hopes, dreams, fears,
anxieties, preferences, intentions and
prioritiesBehavior is also a method to cope
with or respond to demands from others control
and impulses, conform to generally accepted
social conduct, and or influences of the
environmentBehavior is the result of complex
neurological and sensory process.
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He Had A Behavior
Of course he had a behavior! If he didnt hed
be DEAD!
There is walking behavior
talking behavior sitting behavior standing
behavior smiling behavior eating behavior
Have you ever been outside when there wasnt any
weather?
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Behavioral Definition

• Definition of behavior needs to be clear,
  concise, and specific
• A description of what you will see when the
  behavior occurs.
• Written so that everyone can agree when the
  behavior occurs.
• When you talk about behavior, use these rules..

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Specific Target Behaviors

• Examples
• high-pitched scream
• Kicks chair over
• Hits others/self
• Completes tasks

• Non-Examples
• Poor impulse control
• Angry, frustrated
• Aggressive
• Pay attention

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Lack of Understanding
To call someone lazy, uncooperative or stubborn
is to admit we dont understand them.
Shes just plain stubborn. She refused to take
her meds again!
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Step 1 Gather Information

• Functional Assessment

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What is Functional Assessment

• A functional assessment is a process for
  identifying clear, predictive relationships
  between events in a persons environment and
  occurrences of a challenging behavior.
• Not a data collection form
• Not an event

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Why Conduct a Functional Assessment?

• provides clear information
• allows strategies to be based on the function(s)
  of challenging behavior
• leads to more durable outcomes
• reduces the need for reactive interventions and
  crisis plans
• addresses the needs of an individual
• increases quality of life

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Find answers to the BIG Questions

• Under what conditions do the challenging
  behaviors occur?
• What are the outcomes?
• Under what conditions do the challenging
  behaviors not occur

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A Functional Assessment Identifies Goals of
Intervention

• Defines specific target behaviors to increase and
  decrease
• Pinpoints circumstances in which intervention
  will occur
• Identifies desired lifestyle changes, such as
• Participation in integrated activities
• Enhanced independence and satisfaction
• Expanded social networks
• Work!!! ?

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What are the basics?

• Gather information about the challenging behavior
  through direct observation, interviews, record
  reviews and/or rating scales
• Develop a hypothesis after analyzing the
  information regarding the variables that starts
  and maintains behavior

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The ABCs of a Functional Behavioral Assessment

• Setting Event
• the state a person is in, e.g., the person is
  tired, or hungry a state that predisposes a
  person to behave in a certain way given a
  particular antecedent.
• Antecedents
• any stimulus which precedes a behavior
  occurrence
• Behaviors
• any observable act of an individual the
  activity one performs in the presence of a
  particular stimulus
• Consequences
• the events which occurred following behavior

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What are Consequences?

• Consequences are events that follow a behavior.

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Results or Functions of Behavior
Get
Sensory
Attention
Tangible
Get Away
Sensory
Attention
Tangible
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Results or Functions of Behavior

• Sensory
• Escape
• Attention
• Tangible
• Meet an unmet need

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Why do people display challenging behaviors?

• Biological/Medical Reasons
• Drugs/medicine
• Seizure activity
• Allergies/hormonal changes
• To mask pain or discomfort
• Self-Regulation
• To maintain a level of arousal
• Reaction to a change in sensory input

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• Reinforcement
• Internal-it feels good
• External-to serve a purpose in ones environment
• Absence of Alternative Skill
• Most behaviors have the goal to communicate
• Messages are sent through behavior
• Control is the key word

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Alternative Behaviors

• What is the best way to decrease a behavior that
  is a barrier to getting a life?
• Find an alternative behavior that serves the same
  function or purpose gets the same results.

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Agency Examples of ABC

• Practice identifying ABCs specific to
  organization.

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• Strengths-based slide?
• Baskets A B C
• Value of Life-Pomeranz

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Competing Behavior Pathway
Desired Behavior
Consequence
Setting Event
Antecedent
Problem Behavior
Consequence
Alternative Behavior
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Desired Behavior
Typical Consequences
Interact nicely do whats asked
Staff R Asked to do something
Problem Behavior
Setting Events
Triggering Antecedents
Maintaining Consequences
Scream, Hit head
Approach by Staff
Staff move away avoid request
Tired
Acceptable Replacement Behavior
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• Take what you can get closest to what you want!
  Reinforce even small improvement or steps to
  reaching the objective

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• Step 2 Develop a Hypothesis

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What is a hypothesis

• Your best guess about the function of
  challenging behavior

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Hypothesis Formula

• When this occurs (what is the setting
  event/antecedent).
• The individual does (behavior)
• To access or avoid (consequences or functions)

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A Sample Hypothesis

• When Sean..
• (setting event) did not get to sleep before 11
  p.m. the previous evening or does not feel well,
• (antecedent) is not engaged with others or when
  hes engaged in activities for 15 minutes or
  longer
• (behavior) he screams, slaps his face and pulls
  his hair
• (Consequences/function) to gain access to staff
  attention

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Linking Hypothesis Statement to Behavior
Interventions

• A hypothesis statement links behavior
  interventions to
• short-term prevention of problematic situations
• Teaching alternative skills
• Responses to challenging behaviors, including
  crisis management
• Long-term prevention
• Lifestyle changes

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In any situation there are three things involved

• 1 The Environment
• 2 The person
• 3 YOU
• It cannot be guaranteed that you will be able to
  control the environment or the person served
  however, you can control your own behavior.

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What is a Behavior Support Plan

• A written document that summarizes strategies
  that assist in preventing challenging behavior
  from occurring and helps the consumer learn new
  skills
• The plan should
• develop and maintain skills
• enhance opportunities for learning and
  self-fulfillment
• Focus on positive rather than negative techniques

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A support plan is not written in stone. It was
made to be changed as a person grows and changes.
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Is the plan working?

• Are there improvements in challenging behavior?
• Are there increases in skill development?
• Are there improvements in quality of life?
• Increased participation
• Increases choice/decision making
• Inclusion
• Are there improvements in satisfaction?
• Consumer and family
• Staff and others
• Are there improvements in health or well-being?

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How do we collect this information?

• Direct observation data
• Incident reports
• Interviews
• Consumer
• Parents
• Service providers
• Others
• Informal anecdotal reports
• Communication logs
• Progress notes

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Remember, PBS is all about

• Determining the function of challenging behavior
  and then
• Changing environments
• Teaching new skills
• Addressing quality of life issues
• Changing our patterns of interaction

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Review Training Objectives

• To learn what PBS is as both philosophy and tools
• Learn the basics of how we set the tone for the
  environment-to help or hinder
• Learn basic tools of PBS
• Learn how to use data to drive decisions

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Point of View

• When you change the way in which you see
  things-the things you see will change.