Behavioral Consultation Case Presentation. Cori Brown Psychology 636 Fall 2011 California State University, Chico

Transcription

1 Behavioral Consultation Case Presentation Cori Brown Psychology 636 Fall 2011 California State University, Chico

2 Client Demographics Name: E Sex: Male Grade: 4 th Age: 9 Currently spends 30 minutes a day in an ELD classroom E is a really sweet and sincere boy who wants to do well in school. He rarely bothers others in the classroom; rather, his biggest issue is that he is a distraction to himself.

3 Consultee Demographics Name: Ms. Hill Age: 26 Experience: 3 years Teaches Kindergarten and 4 th Grade Ms. Hill is very energetic, eager to help and has stated that she will do whatever it takes to help E function better in school. It is easy to see how much she cares for her students academic and social well being.

4 The Client s Daily Schedule 8:30-10:00- Morning Routine/Daily Oral Reading/Spelling (Mrs. Conway s class) 10:00-10:20- Morning Recess 10:20-10:50- Targeted Intervention Period (Mrs. Conway) 10:50-11:40- Math (Mrs. Conway) 11:40-12:30- Lunch/Recess *12:30-1:45- Whole Group Language Arts 1:45-2:15- ELD (Mrs. Bryant) *2:15-3:00- Small Group Work [*Where intervention is to take place]

5 Problem Identification

6 Problem Identification: Problem Description Given by Consultee E is one of those kids who is off in their own little world all the time he has no interaction with the world around him as if he is stuck in la la land, just staring off with this glazed look in his eyes that some kids get the topics he talks about independently are all about violent video games. He often gives me all the details of the gore, the violence and the images of chopping off of heads kind of stuff E really lacks confidence in the classroom whenever I call on him to answer a question he replies very hesitantly and always begins by saying: well, maybe or I guess it s, I would really like him to become more assertive with his answers and overall more confident in his abilities. -as stated by Ms. Hill

7 Target Behaviors Operationalized Antecedent Behavior Consequences Code Dimension A1: Seat Work A2: During Direct Instruction B1: *Time Off Task C1: Ms. Hill moves closer to E getting near or in E s line of sight 1:Non Verbal Prompt -Duration (Momentary Time Sampling) C2: Ms. Hill says E! 2:Verbal Prompt C3: Ms. Hill taps his desk C4: Verbal redirection by peer 3:Partial Physical Prompt 4: Verbal Prompt A3: When asked to answer a question in class B2: **Low Confidence Responses C5: Ms. Hill offers a choice: -rephrase answer without using Maybe, I guess or Um -say I don t know 5: Verbal Prompt -Frequency (Interval Recording/ Event Sampling) -Latency (Not to be Measured) (See Sequence Analysis to follow on next slide) *Time Off Task is defined by the presence of at least one of the following: starring off in class, drawing, back turned to Ms. Hill during direct instruction. **Low Confidence Responses (LCRs) are defined by the presence of at least one of the following: E s hesitation to answer (wait time before answering), Maybe, I guess,or Um preceding his answer.

8 Sequence Analysis for B2: LCRs A3: E is asked to answer a question in class B2: E gives a LCR C5: Ms. Hill offers E a choice to: a) Rephrase answer to be a HCR b) Say I don t know High Confidence Responses (HCRs) are defined by responses, where by behaviors that are an indication of LCRs, are absent. B3: HCR B4: I don t know C6: Verbal Praise- Good Job! (Positive Reinforcement) C7:Verbal prompting to guide him to the answer C8: Ms. Hill verbally prompts/ asks Eduardo to call on another classmate to answer the question.

9 Instructions for Data Recording: -At the end of every 10 minute interval, simply observe E s behavior at the BOLDED time indicated below and circle whether he is *ON Task by circling ON or *OFF Task by circling OFF in the box above the bolded time. It is only at the specific times in BOLD that you need to observe and then record ON/OFF Task behavior. -Throughout each 10 minute interval, please indicate with a tally mark, in the lowest box, the number of E s responses that are Low Confidence Response (LCR), High Confidence Response (HCR), or if E says I don t know (IDK). Target Behaviors Defined: *Off Task behavior is defined by E exhibiting at least one of the following: staring off in class, observing others when supposed to be participating, E s back turned during direct instruction, and/or drawing when supposed to be attending to instruction or doing seat work. *On Task behavior is defined by the absence of Off Task behaviors. *Low Confidence Responses (LCRs) defined by: responses beginning with I guess, Maybe or Um *High Confidence Responses (HCRs) defined by responses, where by behaviors that are an indication of LCRs, are absent. YES/NO YES/NO YES/NO YES/NO YES/NO YES/NO 12:30-12:40 12:40-12:50 12:50-1:00 1:00-1:10 1:10-1:20 1:20-1:30 LCR HCR I DK LCR HCR IDK LCR HCR IDK LCR HCR IDK LCR HCR IDK LCR HCR IDK YES/NO YES/NO YES/NO YES/NO YES/NO LCR 1:30-1:40 HCR DK *ELD* *ELD* *ELD* 2:15-2:25 LCR HCR IDK 2:25-2:35 LCR HCR IDK 2:35-2:45 LCR HCR IDK 2:45-2:55 LCR HCR IDK

10 Baseline Data: On/Off Task Behavior

11 Percentage of Time On/Off Task 53% 47% On T a sk Off T a sk

12 Percentage of Time On/Off Task Proportion of On/Off Task Behavior by Time of Day 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 12:40 12:50 1:00 1:10 1:20 1:30 1:40 2:25 2:35 2:45 2:55 On Task Off Task Time of Day

13 Duration in Minutes Duration of Time On/Off Task Day of Baseline On Task Off Task

14 Percentage of Time On Task Baseline Data for On Task Behavior 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Baseline Day of Baseline/Intervention On Task Criterion Aim Line

15 The Baseline Data: LCR/HCR

16 Total Baseline Responses The Proportion of LCRs and HCRs IDKs HCRs LCRs 0 Type of Response

17 Percentage of Responses Baseline Data of HCRs 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% HCRs Criterion Aim Line Baseline Day of Baseline/Intervention

18 Percentage of Responses Baseline Data for LCRs 100% 90% 80% 70% 60% 50% 40% 30% LCRs Criterion Aim Line 20% 10% 0% Baseline Day of Baseline/Intervention

19 Problem Analysis

20 Problem Analysis Interview E Enjoys: Playing video games (especially with is brother) Building things with legos, boards and nails Movies with racing cars (The Fast & The Furious) Collecting Hot Wheels Playing imaginary battle games with his friends (Star Wars and Jedi warriors) or basketball during recess Spending time with is father who he doesn t get to see often Language Arts

21 Relevant Background Information Second youngest out of four boys; all four have shown to have behavioral problems in school. Enjoys school and wants to perform well Unaware of his lack of focus, off task behavior is unintentional 2-3 hours a day playing video games, often 6-8 hours a day on the weekends. Conversations at school center around the details of the video games he plays. Misses his father, spends time together building things and playing/discussing video games.

22 Hypotheses for Problem Behaviors Consultee s Perspective: Lack proficiency with the English language leads to: LCRs General low confidence in the classroom, which leads E to lose focus easily (Off Task behavior). Consultant s Perspective: Agree that E s hypothesized low confidence in speaking English and overall low confidence in the classroom contributes to his LCRs. Positive relationship with the high intensity in which E plays video games and his Off Task behavior in classroom. increased hours of playing video games contributes to increased duration of Off Task behavior distortions in his reality and likely overall desensitization with typical daily activities Video games reinforcing on many levels Immediate gratification Time spent/bonding with father Cyclical relationship between Off Task behavior and E s generalized low confidence in the classroom.

23 Target Behaviors: The Intervention Off Task behavior defined by staring off in class, observing others when supposed to be contributing to group work, back turned away from direct instruction, drawing. On Task behavior defined by the absence of Off Task behaviors. LCRs defined by responses beginning with I guess, Maybe or Um. HCRs defined by responses, where by behaviors that are an indication of LCRs, are absent. Procedures: Differential Reinforcement of Incompatible (DRI) responding to decrease both Off Task behavior and LCRs and increase both On Task behavior and HCRs. Shaping to increase On Task behavior and of HCRs. Token System in which the client can earn tokens for performing desirable behaviors and can cash in such tokens for backup reinforcers.

24 DRI Rationale for Intervention Procedures Used withholding of reinforcement for Off Task behavior and LCRs and in turn reinforcing only incompatible behaviors of On Task behavior and HCRs. Shaping deficiency of a particular behavior, in this case, On-Task Behavior and HCRs Reinforcement of successive approximations of both On Task behavior and HCRs and the extinction of earlier approximations of the behaviors, On Task behavior and HCRs will occur as new behaviors. Token Systems when immediate reinforcement is not possible or not realistic to increase motivation in the client

25 Details of the Intervention and Procedures to be Used On/Off Task behavior: If at the end of the ten minute interval E is displaying On Task behavior. he is immediately reinforced with verbal praise You should be proud of yourself for staying On Task! AND reinforced with the opportunity to move his race car one space forward (secondary reinforcer) PAIRED WITH E s choice of an activity from the (R+) menu (primary/backup reinforcer) in which he is to immediately engage in for 3 minutes. E will not receive reinforcement for Off Task behavior. E must exhibit On Task behavior for (N) intervals (N) will increase over time. HCRs/LCRs: Whenever E responds using a HCR, he will immediately be reinforced with: verbal praise, You should be so proud of that confident response! Way to go! AND reinforced with the opportunity to color his race car located on his desk. E will not receive reinforcement for LCRs or IDK responses. E must provide N% of HCRs/Day (N) will increase over time.

26 *N Phase 1: N=1 Interval Phase 2: N=3 Intervals Phase 3: N=5 Intervals Phase 4: N=6 Intervals Phase 5: N=7 Intervals Phase 6: N=8 Intervals Phase 7: N=9 Intervals Phase 8: N=10 Intervals Phase 9: N= 11 Intervals Flow Chart for On/Off Task Behavior Whole Group Language Arts/ Small Group Work (12:30-2:55) End of 10 Minute Interval E exhibits On Task behavior N number of intervals between 12:30-2:55 (*N will increase at each phase) E exhibits Off Task Behavior E is immediately reinforced with verbal praise: You should be proud of yourself for staying On Task! AND allowed to move his race lsjflk car one space forward PAIRED WITH E s choice of an activity from the (R+) menu in which he is to engage in for 3 minutes. No verbalizations are made, (R+) is not delivered

27 Intervention Phases for On Task Behavior Phase Criterion [Number of Intervals Exhibiting On Task Behavior Required to Receive (R+)] Required Minutes Exhibiting On Task Behavior (1 Interval = 10 Minutes) # of Days at Phase Phase 1 N=1/11 [Priming the reinforcer: token (secondary reinforcer) needs to be paired with choice from reinforcement menu and verbal praise (primary reinforcers)] 10 Minutes/110Minutes (total required between 12:30-2:55) 2 Days Phase 2 N=3/11 30 Minutes/110 Minutes (total required between 12:30-2:55) 2 Days Phase 3 N=5/11 50 Minutes/110 Minutes (total required between 12:30-2:55) 5 Days Phase 4 N=6/11 60 Minutes/110 Minutes (total required between 12:30-2:55) 5 Days Phase 5 N=7/11 70 Minutes/110 Minutes (total required between 12:30-2:55) 5 Days Phase 6 N=8/11 80 Minutes/110 Minutes (total required between 12:30-2:55) 5 Days

28 Intervention Phases for On Task Behavior Continued Phase Criterion [Number of Intervals Exhibiting On Task Behavior Required to Receive (R+)] Required Minutes Exhibiting On Task Behavior (1 Interval = 10 Minutes) # of Days at Phase Phase 7 N=9/11 90 Minutes/110 Minutes (total required between 12:30-2:55) 5 Days Phase 8 N=10/ Minutes/110 Minutes (total required between 12:30-2:55) 5 Days Phase 9 N=11/ Minutes/110 Minutes (total required between 12:30-2:55) 5 Days *Note: Due to the time limit made by the ending of the semester, it was originally planned that this intervention would continue on during the following semester; that is, until criterion is met and maintenance/generalization procedures have been carried through.

29 Sample Reinforcement Menu for On Task Behavior Sentence Identification Worksheet w/ Video Game Content Video Game or Race Car Story Board Languages Arts Computer Game Peer-to-Peer Tutoring

30 *N Phase 1: N=20% HCRs Phase 2: N=40% HCRs Phase 3: N=60% HCRs Phase 4: N=80% HCRs Flow Chart for HCRs/LCRs: Ms. Hill asks E a question in class E gives N% of HCRs between 12:30-2:55 (*N will increase at each phase) E gives a LCR E gives an IDK response E is immediately reinforced with verbal praise: You should be so proud of that confident response! Way to go! AND the opportunity to color his race car located on his desk. E is prompted to provide either a HCR or IDK response (R+) is not delivered

31 Intervention Phases for HCRs Phase 1: N = 20% ( E averaged 19% HCRs/day, during baseline). Out of E s total responses, he will need to provide 20% HCR/day in order receive reinforcement (verbal praise and the opportunity to color his race car). Phase 2: N = 40%; E will need to provide 40% HCRs/day in order to receive reinforcement. Phase 3: N = 60%; E will need to provide 60% HCRs/day in order to receive reinforcement. Phase 4 (Criterion): N = 80%; E will need to provide 80% HCRs/day in order to receive reinforcement. Progression of Intervention Phases Phase Criterion [The Percentage of HCRs Required to Receive (R+)] Phase 1 N=20% HCRs 5 Days Phase 2 N=40% HCRs 5 Days Phase 3 N=60% HCRs 5 Days Phase 4 N=80% HCRs 5 Days # of Days at Phase

32 Intervention Implementation

33 Percentage of Time On Task Intervention Data: On Task Behavior 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Day of Baseline/Intervention Baseline P1 P2 P3 P4 P5 P6 P7 P8 P9 On Task Criterion

34 Proportion of On/Off Task Behavior On Task Behavior Continued 100% 90% 80% 70% 60% 50% 40% 30% On Task Off Task 20% 10% 0% Day of Baseline/Intervention

35 Percentage of Responses 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Intervention Data: HCRs Baseline P1 P2 P3 P4 Day of Baseline/Intervention HCRs Criterion

36 Total Opportunities to Respond Intervention Data: Proportion of HCRs/LCRs/IDK Responses Across Phases IDK HCRs LCRs Baseline Phase 1 Phase 2 Phase 3 Phase 4 The Course of Intervention Implementation

37 Plan Evaluation

38 Percentage of Time On Task Plan Evaluation: On Task Behavior 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 28% Increase 47% 75% Baseline Phase 5 Baseline Compared to Last Completed Intervention Phase

39 Average Percentage of Time On/Off Task Plan Evaluation: On Task Behavior Continued 100% 90% 80% Progression of Phases Measures of Central Tendency for Time On Task % Change from Baseline 70% Baseline M=47%, SD=15% N/A 60% 50% 40% 30% 20% 10% 0% Baseline Phase 1 Phase 2 On Task Phase 3 Off Task Phase 4 Phase 5 Phase 1 M=87%, SD=5% 40% Increase Phase 2 M=73%, SD=14% 26% Increase Phase 3 M=69%, SD=4% 22% Increase Phase 4 M=71% SD=7% 24% Increase Phase 5 M=75%, SD=7% 28% Increase Phase 6 (In progress) (In Progress) Baseline/Intervention Phase Phases 7, 8, 9 N/A (To be implemented the following semester) N/A

40 Percentage of Time On Task 100% 90% 80% 70% Projected Date of Goal Attainment 60% 50% On Task Criterion Trend Line 40% 30% 20% 10% 0% Baseline P1 P2 P3 P4 P5 P Day of Baseline/Intervention

41 Percentage of HCRs Plan Evaluation: HCRs 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 65% Increase 84% 19% Baseline Phase 4 Baseline Compared to Final Phase

42 Percentage of LCRs Plan Evaluation: LCRs 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 65% 57% Decreas e 8% Baseline Phase 4 Baseline Compared to Final Phase

43 Plan Evaluation: Measures of Central Tendency for HCRs Baseline: M=19% HCRs, SD=10% Phase 1: M=59% HCRs, SD=16% % increase from baseline: 40% Phase 2: M=59% HCRs, SD=13% % increase from baseline: 40% Phase 3: M=75% HCRs, SD=14% % increase from baseline: 56% Phase 4: M=84% HCRs, SD=9% (Criterion Attained) % increase from baseline: 65%

44 Analysis and Interpretation of Intervention Data On Task Behavior: The intervention has progressed as designed, showing a 28% increase in On Task behavior in 20 days. The aim line required a 1.3% increase in On Task behavior per day actual increase per day averages 1.6% Not all phases of the intervention are complete, Phases 6, 7, 8 and 9 (19 days) remaining. The projected date of goal attainment was found by extrapolating the data with the use of a trendline. It is estimated that criterion will be obtained on day 41 of phase 9, which is within the time originally predicted. Once criterion is maintained for at least 2 weeks, plans for generalization will be implemented (further discussion to follow) HCRs: Goal attainment has successfully been reached E is currently providing on average 84% HCRs in the classroom, 8% IDK responses and only 8% LCRs Plans for maintenance and generalization are underway.

45 Consultee s Plan Evaluation Changes in Client s Behavior Increased focus and attention Greater awareness of own behavior Increased motivation and engagement in class activities Greater opportunities to gain (R+) from peers through targeted behavior changes Increase levels of general confidence in the classroom as well as increased usage of HCRs Gains in academic success (greater homework completion, better understanding of instructional concepts) Attitude toward Behavioral Consultation & Skill Acquisition Acquired specific strategies and skills to be used in future situations Increased confidence and feelings of competence Positive attitude toward behavioral consultation services and increased likelihood of using such services in the future The conusltee is very happy with the results of the intervention thus far; stating: I have thoroughly enjoyed this experience and all that I have learned form the process. I am so proud of the work we have done to help E function better in school. -Ms. Hill

46 Consultant s Plan Evaluation Observable Differences in Client Behavior Personal Perspective Positive outcomes for all members: client, consultee and consultant An opportunity to add to my repertoire of skills Importance and effectiveness of behavioral consultation Primary Reasons for Intervention Success Highly variable behavior during baseline Proper planning and design of the intervention Salience and strength of reinforcers implemented Use of a token system and reinforcement menu generalized conditioned reinforcers instead of a simple conditioned reinforcer Many opportunities for the primary and secondary reinforcer to be paired Client characteristics Integrity of the intervention implementation Strength of the Consultee and Consultant relationship Support of colleagues and school personnel

47 Maintenance & Generalization

48 Maintenance & Generalization Maintenance: In order to begin the process of generalization it is best practice to insure that the behavior remains at criterion for at least two weeks after initially meeting goal attainment, this being the maintenance phase. 2 weeks of post-implementation recording Continue to implement the intervention at the final intervention phase Requiring On Task Behavior= 110 Minutes/100% of time On Task Requiring HCRs= at or above 80% Precede with Generalization Objectives: gradually eliminate tangible reinforces entirely through process of thinning reduce the frequency of verbal praise to an amount that is consistent with the verbal reinforcement provided by peers in the natural environment Training situation=natural environment Contingency Plan for Reversal of Target Behaviors: Follow up observations to assess target behaviors Vigilant observation and monitoring of the generalization process Reinstate the intervention at the phase that best fits the reverse in behavior

49 Implementation of Generalization Week 1: On Task Behavior~ Begin thinning of reinforcement menu items Provide verbal reinforcement AND allow to move his race car one space forward PAIRED WITH a choice from only two items (out of the original four) on the reinforcement menu for which he is to engage in, these being Language Arts Computer Games or Peer Tutoring Strength of these reinforcers high Peer Tutoring-most academically appropriate and consistent with the natural social reinforces E will receive from peers HCRs~ Provide E with verbal reinforcement only Reduction in reinforcing value of coloring race car, loss of interest Verbal reinforcement remained highly reinforcing and alone appeared to be maintaining HCRs Week 2: On Task Behavior~ Provide verbal reinforcement AND move race car forward one space PAIRED WITH Peer Tutoring HCRs~ reduce verbal reinforcement to a level that is consistent with the natural environment

50 Week 3: Implementation of Generalization Continued On Task Behavior~ Provide verbal reinforcement AND move race car one space forward, WITHOUT opportunity to engage in any of the reinforcement menu activities Week 4: On Task Behavior~ Provide only verbal reinforcement Such verbal reinforcement should continue to be thinned until it s frequency and quality is consistent with the verbal praise provided by peers. Verbal praise will ideally be a naturally reinforcing contingency that will operate in the natural environment to maintain high level of HCRs and increased durations of On Task behavior.

51 Please contact me directly with questions or comments at: