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Autism Q and A: Positive Behavior Support Plans

by Dawn Hendricks

Available formats:    Word


Positive behavior support is an all-encompassing system of behavior management. Behavior is supported through a structured plan that positively addresses the person’s behavior as well as his or her quality of life. Positive behavior support is based in the principles of applied behavior analysis (ABA) and involves understanding factors that impact behavior including antecedents and consequences. It is also embedded in the values of person centered planning.

Person centered values require intervention and support tailor-made to meet the needs and unique goals of the individual, with movement towards community and social involvement and personal choice. The fundamental philosophy of positive behavior support is that most behavior, challenging or adaptive, serves a specific function or purpose in the life of the person. This Autism Q and A will provide basic information about developing positive behavior support plans. Please see our website for additional fact sheets on this topic.

 

Question: What is a positive behavior support plan?

Answer: A positive behavior support plan outlines the supports and strategies to be implemented for reducing problem behavior and for teaching positive skills designed to replace the behavior. The plan is developed once the team has an understanding of the function of the interfering behavior. A positive behavior support plan provides sufficient detail so all team members have a clear understanding of what to do to prevent problem behavior from occurring, to teach new skills, and how to respond when the behavior occurs.

There are three parts of the plan:

  1. antecedent and setting event supports and strategies,
  2. teaching new behaviors, and
  3. increasing reinforcement for the new behavior while changing the team’s response to the problem behavior.

All three parts are essential to achieving true change in problem behavior.

 

Question: What are the steps in developing a positive behavior support plan?

Answer:The positive behavior support process involves multiple steps and includes activities that help determine the function of the behavior as well as development of a behavior support plan.

  1. Determine an objective and clear definition of the interfering behavior.
  2. Determine the function of the behavior through data collection, information gathering, and development of a hypothesis that outlines the setting event, antecedent, consequence, and function for the problem behavior.
  3. Develop a positive behavior support plan that explicitly outlines what to do to proactively prevent the behavior and/or identify the skills to be taught to replace the behavior.
  4. Implement the plan across environments and with consistency.
  5. Monitor and evaluate progress on the plan and development of new, positive skills through data collection and analysis.

 

Question: What are antecedent and setting event supports and strategies?

Answer: Antecedents are events that come before the behavior that cause its occurrence. There are two types of triggers that may impact the presence of a problem behavior. An antecedent, or fast trigger, is an event that occurs right before the behavior and results in the quick activation of the behavior. For example, Taylor hits his teacher when presented with a math worksheet. Presentation of the worksheet is the antecedent.

The other type of antecedent is called a setting event. Setting events result in the slow activation of the behavior. In other words, they set the stage for the behavior making it more likely to occur. Simone will sometimes cry during reading groups and will scream “computer” as she prefers this task. This is more likely to happen when she has had physical education in the morning. Going to P.E. is a setting event that results in Simone crying during reading.

As a component of a positive behavior support plan, the team can implement a number of strategies to alleviate the triggers that frequently result in problem behavior. The best way to do this is to implement antecedent and setting event supports and strategies. The most logical way to eliminate a problem behavior is to eliminate the antecedents that lead to the occurrence of the problem behavior. This requires the teacher or paraprofessional prevent the problem behavior from occurring by mitigating the person’s need to engage in it.

Sometimes it might be possible to prevent the challenging behavior all together. It may not be possible to entirely remove an antecedent to a problem behavior, however. For example, Taylor’s teacher could decide to never give him a math worksheet again, thus removing the antecedent and eliminating the problem behavior. However, on occasion, she does need to give a worksheet for math practice. But in the future, the worksheet could be altered so one problem is presented at a time, reducing Taylor’s stress and changing his response.

 

Question: What are examples of setting event and antecedent supports and strategies?

Answer: There are many ways antecedents and setting events can be altered to reduce or prevent the likelihood of problem behavior.

The following are some examples of strategies and supports.

  1. Minimize the impact of the antecedent by pairing it with a desired item, event, or activity.
    Perhaps Taylor would not mind completing the worksheet if his teacher were laying music; offered him a snack when it was presented; or incorporated robots, his favorite toy, on the worksheets.
  2. Intersperse mastered work with work that presents more challenge to the student.
    By interspersing mastered work with challenging work, students gain confidence and motivation making the challenging work less frustrating.
  3. Provide frequent breaks to minimize stress around problem situations.
    This is an important antecedent strategy, particularly for students whose problem behavior functions to avoid work. Perhaps Simone would benefit from a break prior to reading groups on days when there is P.E. in the morning.
  4. Offer more choices to the student across the day.
    This simple strategy makes a huge difference in the lives of students. Offering choices of activities, tasks, materials, location to complete work, and other similar choices frequently results in fewer problem behaviors. During math, Taylor has three tasks to complete: worksheet, Math Wiz computer game, and small group instruction. Taylor chooses the order in which he completes these tasks giving him control over when he does the worksheet.
  5. Increase predictability.
    Many students with ASD have difficulty predicting their own daily schedule. Teams can increase the student’s tolerance of less desired activities by providing them with visual schedules. The student can then see what activity is coming next, which allows the student to predict his/her daily schedule. Picture schedules work best when the student can see that work is followed by a break or desired activity.

 

Question: How do I teach functional skills to replace the problem behavior?

Answer: Teaching functional skills to replace the problem behavior is the central behavior change strategy in a positive behavior support plan. The team can narrow the function of problem behavior into five major purposes:

  1. seeking attention from others;
  2. seeking something tangible, i.e., item, activity, or food;
  3. seeking sensory input from the action itself;
  4. avoiding a person, task, item, or environment; or
  5. demonstrating medical discomfort.

The direct replacement skill to be taught will vary depending on the function. Juan displays problem behavior to get attention from others and is taught the phrase, "play with me," while Simone is taught to say, "computer, please."

The new skill must result in the same outcome as the problem behavior and must be carefully considered. The new skill must be as efficient and as effective as the problem behavior! If the functional skill is not, why would the person ever use it? For example, if Morgan screams to get a break from a work task, then the teacher will want to teach her to ask for a break. Morgan is nonverbal, so the teacher will not want to require her to verbally ask for a break. Instead, she is taught to tap a card that reads "break." This is easy for Morgan to do and is more effective than screaming.

The team must actively teach the new skill. The plan should outline when, where, and how the skill will be taught. Often, teaching the skill will happen when the student has a need for this new behavior. For example, if Morgan begins to scream, her teacher can use this as an opportunity to teach her to ask for a break. Additionally, the team will want to identify times when they can create and structure situations to teach this new skill. Morgan may not engage in the problem behavior frequently enough to learn to ask for a break. Therefore, her team determines to present her with a work task multiple times a day and immediately prompts her to request a break. So by the end of the day, Morgan has practiced this new skill many times.

 

Question: How do I reinforce the new behavior and put the old behavior on extinction?

Answer: Problem behavior occurs because it has worked for the individual! To reduce the effectiveness of the behavior and increase the use of a new replacement behavior, the reinforcement must be changed. The team must remove the reinforcing value of the problem behavior and increase the reinforcement applied to the new behavior. Because Morgan's problem behavior was reinforced by avoiding work tasks, her new behavior should also result in avoiding work tasks. In other words, when Morgan taps her "break" card, she should get a reprieve from work, just like she did when she screamed. In this case, there is no need to purchase expensive trinkets or set up different reinforcement alternatives, her team can offer the same outcome sought through the problem behavior.

As noted above, the team must provide enough oppor-tunities for the person to encounter the reinforcement provided by exhibiting the new behavior. If students only receive reinforcement one or two times a day, this may not result in learning. As the person is learning this new skill, it is likely that he will continue to exhibit the problem behavior. Remember, this behavior is very engrained and has been reinforced so it will take time for it to disapear and/or be replaced.

The team must be prepared for the behavior and know exactly how to respond when it occurs. Often, when the behavior occurs, the team can use this as a teachable moment and prompt the new behavior. However, the other part of this strategy is to put the old behavior on extinction. Remove all reinforcement from the old behavior and ensure the person does not receive the same thing that he would get from the new behavior. For example, when Morgan screams, her teacher ignores the screaming and calmly prompts her to point to the "break" card. When she does so successfully, she is given a break.

 

Question: How do I make sure the plan is working?

Answer: The team must ensure that the positive behavior support plan is effective. A system to evaluate the plan must be developed and implemented. This involves collecting and analyzing data. Data helps determine whether the person is developing new, positive skills and is reducing the use of the problem behavior. Data can be collected on different measures and can take many different forms. Data is frequently collected on the use of the new replacement skill. For example, Morgan's teacher collects data on the number of times she asks for a break. However, the team may also take data on the occurrence of the problem behavior. Simultaneously, Morgan's teacher takes data on the number of screams that occur each day.

Common types of data include frequency, or the number of times a behavior occurs; duration, or the length of time the behavior occurs, or the latency. Latency is the amount of time it takes for the person to engage in the new behavior. Latency is helpful when a student is moving towards independence and prompts are being faded. For Morgan, once she is requesting a break when her teacher points to the break card, her teacher changes the data collection methodology to latency to work towards minimizing the amount of time between the gesture prompt and Morgan's request.

Team members should analyze the data frequently to make sure the plan is effective, and the person is being supported. If positive behaviors are not being learned, the team will want to make changes to the plan. At the end of the week, Morgan’s teacher graphs both behaviors to ensure the number of times Morgan requested a break goes up, while the number of screams goes down.

 

Summary

A positive behavior support plan outlines the supports and strategies to be implemented by team members to reduce the occurrence of problem behavior through positive and proactive means. A positive behavior support plan is developed once the team has an understanding of the function of the interfering behavior. Otherwise, there might be a mismatch between the function of the behavior and the function of the new skill.

There are three parts of the plan:

  1. antecedent and setting event supports and strategies,
  2. teaching new behaviors, and
  3. increasing reinforcement for the new behavior while changing the team’s response to the problem behavior.

The combination of the three plan elements results in teaching the person functional behaviors that will assist them in their future success. These are the critical elements that result in long term behavior change. With this combination of plan elements, positive behavior support plans can result in the acquisition of functional skills and sustainable behavior change.

For additional information, the following resources are recommended.

Bambara, L. M. & Knoster, T.P.  (2009). Designing Positive Behavior Support Plans (2nd ed.).  American Association on Mental Retardation: Washington, DC.


Carr, E.G., Horner, R. H., Turnbull, A. P., Marquis, J. G., McLaughlin, D. M., McAtee, M. L., Smith C. E., Ryan, K. A., Ruef, M. B., Doolabh, A., & Braddock, D.  (1999). Positive Behavior Support for People with Developmental Disabilities: A Research Synthesis.  Washington, DC: AAMR.


Hieneman, M., Childs, K., & Sergay, J.  (2006). Parenting with Positive Behavior Support: A Practical Guide to Resolving Your Child’s Difficult Behavior.  Baltimore: Brookes.


Horner, R. H.  (2000). Positive behavior supports.  Focus on Autism and Other Developmental Disabilities, 15, 97-105.


Machalicek, W., O’Reilly, M. F., Beretvas, N., Sigafoos, J., & Lancioni, G. E.  (2007).  A review of interventions to reduce challenging behavior in school settings for students with autism spectrum disorders.  Research in Autism Spectrum Disorders, 1, 229-246. 

For additional information on ACE please go to our website: www.vcuautismcenter.org

Contributors for this issue: Dawn Hendricks, Ph.D.
Editor: Becky Boswell, M.B.A.

Information for this Frequently Asked Questions (FAQ) is from Virginia Commonwealth University's Autism Center for Excellence (VCU-ACE), which is funded by the Virginia StateDepartment of Education (Grant # 881-61172-H027A100107). Virginia Commonwealth University is an equal opportunity/affirmative action institution providing access to education andemployment without regard to age, race, color, national origin, gender, religion, sexual orientation, veteran's status, political affiliation, or disability. If special accommodations or language translation are needed contact (804) 828-1851 VOICE -- (804) 828-2494 TTY.

 


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