12/19/2016. Autism Spectrum Disorders & Positive Behavior Supports a brief overview. What is the Autism Spectrum? Autism Spectrum Disorder

Transcription

1 Autism Spectrum Disorders & Positive Behavior Supports a brief overview What is the Autism Spectrum? DSM V (2013) included revisions with more specific diagnostic criteria and Further distinctions will be made according to severity levels. The severity levels are based on the amount of support needed, due to challenges with social communication and restricted interests and repetitive behaviors. For example, a person might be diagnosed with Autism Spectrum Disorder, Level 1, Level 2, or Level 3, (ARI, 2014) All of the disorders on the spectrum are characterized by: Deficits in social reciprocity and interaction Deficits in verbal and nonverbal communication Repetitive and stereotyped behaviors Autism Spectrum Disorder Each person with autism is an individual and is affected in different ways. There is much variety in terms of: Communication impairment Social impairment Repetitive behaviors (such as self-stimulation or ritualistic behaviors) Cognitive ability Disruptive behaviors (such as aggression or self-injury) Mild Severe 1

2 Communicative Impairments Delay or lack in development of verbal language. Most young children with autism have little or no spoken language. Approximately 40% of individuals never develop speech. Impaired conversational skills. Some individuals will only talk about their interests, do not ask others questions, etc. Communicative Impairments Repetitive and nonfunctional speech (echolalia) Examples include repeating what has just been said or reciting lines from movies. Limited or absent use of gestures Individuals without speech do not attempt to compensate through gestures, pointing, or mime. Young children do not wave bye-bye, etc. Social Impairments Impaired use of multiple nonverbal social behaviors to regulate social interactions. These include eye contact, facial expressions, body postures, and gestures. Lack of developmentally appropriate peer relationships. Individuals have difficulty interacting with their peers, forming and maintaining friendships, and interpreting society s rules. 2

3 Social Impairments Lack of spontaneous sharing of enjoyment, interests, or achievements. Lack of, or delayed, pretend and social play. Lack of social or emotional reciprocity. Repetitive Behaviors Unusual sensory play. This may include looking at objects out of the corner of eye, sniffing non-aromatic items, etc. Unusual preoccupations and interests. Examples include a young child who only wants to talk about maps or an adult who collects bottle caps. Many individuals engage in nonfunctional rituals and routines. Distress when their environment and/or schedule is altered. Repetitive Behaviors Repetitive and nonfunctional body movements. These include hand flapping, body rocking, and more complex whole body movements. Persistent preoccupation with parts of objects or lining up objects. An example would be spinning the wheels of a toy car instead of playing with it appropriately. 3

4 Cognitive Abilities The cognitive abilities of those with autism is variable. While some individuals with autism have average or above-average IQ s, the majority have some degree of cognitive impairment. The rate of ID is approximately 60%. ID can range from mild to very severe. Disruptive Behaviors Some individuals with autism exhibit disruptive behaviors. These may include aggression, selfinjury, self-stimulation (e.g., arm flapping, hand gazing, and rocking), screaming, mouthing objects, tantrums, etc. Behaviors can usually be managed through behavioral strategies, increased functional communication, and, in some cases, medication. These behaviors can vary in frequency and intensity and may change over time. Think, pair, share What are the current behavioral challenges in your classroom? What have you put in place to address the challenges? 4

5 A shared belief We cannot make students learn or behave We can however, create environments to increase the likelihood students will learn and behave Environments that increase the likelihood are often characterized by a core curriculum and implemented with consistency and fidelity of school wide supports A foundation of beliefs that include: Focus on what you want students to do instead (replacement behaviors) Look for patterns of behavior that suggest functional relationships Teach replacement behavior and provide multiple opportunities to practice Deliver high rates of positive feedback when students display replacement behavior Classrooms characterized by the following: Classroom expectations & rules defined and taught Procedures & routines defined and taught Continuum of strategies to acknowledge appropriate behavior in place and used with high frequency (4:1) Continuum of strategies to respond to inappropriate behavior in place and used per established school-wide procedure Students are actively supervised Students are given multiple opportunities to respond Activity sequence promotes optimal instruction time and student engaged time Instruction is differentiated based on student need 5

6 Classroom responses might include: Signal an error has occurred (refer to rules, "We respect others in this room and that means not using put downs") Ask for an alternative appropriate response ("How can you show respect and still get your point across?") Provide an opportunity to practice the skill and provide verbal feedback ("That's much better, thank you for showing respect towards others") What not to do! The most effective strategies will fail to impact students in the absence of sincerity, respect, and obvious joy in teaching 6

7 What is Reinforcement? Reinforcement is a consequence that follows a behavior. Reinforcement strengthens the behavior it follows when applied reliably. The contingent delivery of the reinforcing consequence must maintain or increase the behavior in terms of its rate, frequency, duration and or intensity. If it does not, then the consequence is not considered to be reinforcement. Reinforcement Reinforcement can occur naturally or be planned. A student working carefully to complete an assignment because the teacher has recently commented on their work ethic is an example of natural reinforcement. A teacher developing a point system to recognize homework completion or a parent utilizing verbal praise to acknowledge completion of a chore are examples of planned reinforcement. Reinforcement Positive Reinforcement is the contingent presentation of a stimulus that increases the probability of the occurrence of the behavior in the future. Examples include: Verbal praise Smile or nod of approval Proximity and/or touch Choice activity The reinforcer must be meaningful to the recipient! 7

8 Reinforcement Negative Reinforcement occurs when an occurrence of the target behavior is followed by the removal of an aversive stimulus, ultimately resulting in an increase in the target behavior Negative reinforcement is often associated with avoidant behaviors The child who plays sick to avoid a bully. The student who threatens to avoid doing math. Reinforcement To determine whether negative reinforcement is maintaining problem behavior you should ask the following: 1. Does the behavior result in the termination of instructional demands or activities? 2. Does the learner experience difficulties with regard to instructional tasks or demands in question? 3. Does the behavior occur most frequently during subjects in which the learner has the most difficulty? Classes of Reinforcers Edibles Activities Tangibles Token Naturally occurring The reinforcer must be meaningful to the recipient! Consider the students individual needs! 8

9 Principles of Effective Reinforcement Reinforcement must be contingent Reinforcement needs to be immediate Establishing operations Intensity of reinforcer Quality of the reinforcer Reinforcement in Learning Environments Continuous reinforcement most likely applied at the skill acquisition stage Intermittent reinforcement applied during fluency and maintenance building Interval schedules periods of time Ratio schedules number of responses Learning Environments cont. Shaping reinforcement of successive approximations of a target behavior. Successive approximations represent responses that are one step closer to the target behavior Shaping can be used to teach and increase new behaviors as well as systematically reduce excessive or problematic behavior The process of shaping takes time! 9

10 Learning Environments cont. Chaining a sequence of related steps or behaviors or discriminative stimuli and responses. Routines naturally lend themselves to chaining. Student arrives home Eats snack Completes homework Washes hands Prepares for supper These activities can be taught individually or can be linked and taught as a sequence Learning Environments cont. Fading the systematic removal of instructional prompts so that the behavior occurs under natural conditions. A teacher systematically reduces the number of prompts over time as the student becomes fluent and maintains the target level of performance. Replacement Behaviors Positive behavior interventions seek to identify problem behaviors and replace them with alternative behaviors that will improve outcomes for students. Problem behaviors are often linked to skill deficits. 10

11 Replacement Behaviors Skill deficits result when students have not been taught the targeted skill or have failed to develop mastery before instruction was terminated. Common Reasons for Skill Acquisition Failures The activity was to challenging Premature termination of instruction Inadequate reinforcement Skill was not relevant or meaningful Inadequate instruction Replacement Behaviors Positive Replacement Behaviors serve as alternative responses which: Promote the best interest of the student Afford the student expanded options Reduce the likelihood of the emergence of challenging behaviors Lead to greater independence and self determination Replacement Behaviors Research Based Interventions Functional Communication approaches Self Management Differential reinforcement 11

12 Replacement Behaviors Self Management a cognitive behavior intervention method designed to teach learners to self direct their behavior. Involves the individual in the selection of goals, monitoring of behavior, and implementation of intervention strategies Widely used with students with EBD as well as students with LD (to do list, agenda, etc) Replacement Behaviors Differential Reinforcement is designed to increase the frequency of desirable behavior and reduce challenging behavior through the delivery of reinforcement of positive alternative behavior. Three Essential Components Select a functionally equivalent replacement behavior Use direct instruction in teaching the behavior to the student Facilitate access to the same functional outcome thus making the replacement more efficient Resources Scott A. Roderick, MA, BCBA. Director/Senior Board Certified Behavior Analyst Quantum Behavioral Consulting, LLC. OSEP Center for Positive Behavioral Interventions and Supports 12