Engaging the Child with Challenging Behaviors

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1 Engaging the Child with Challenging Behaviors Monica Dowling, PhD Douglene Jackson, PhD, OTR/L, LMT October 26, 2016

3 My name is Monica Dowling. I will be speaking about managing challenging behaviors in children with neurodevelopmental disorders. I have no relevant financial interests or conflicts of interest. I am employed by the University of Miami. I have no financial interests to disclose. 3

4 My name is Douglene Jackson. I will be speaking about managing challenging behaviors in children with neurodevelopmental disorders. I have no relevant financial interests or conflicts of interest. I am employed by the University of Miami. I have no financial interests to disclose. I am the Commission on Education Clinical Fieldwork Educator for the American Occupational Therapy Association and sit on both the Transition and Autism workgroups. I do not receive any compensation for my roles. 3

5 It s ALL about U! Your knowledge! Your skills! Your behavior!

6 Function of challenging behavior

7 Behavior predicts outcomes Neurodevelopmental disorders do not walk alone (APA Spotlight on Disability, Sept 2016) Behavior problems 4x more common than in peers (Emerson, 2013) Impact access to care due to lack of trained professionals (Thompson, 2009)

and participation Your ability to do your job Understand

8 Interventionists Aims Your GOAL is to: Minimize the impact of challenging behavior on Child s performance and participation Your ability to do your job Understand the child Model skills for the parent Use evidence-based practice

9 Pyramid Model The pyramid model for supporting social emotional competence in infants and young children fact sheet Public health model for promotion, prevention, and intervention Universal, secondary, tertiary approaches ramid_model.htm

11 Reinforcement* Prompting* Time delay* Modeling Task analysis

12 Functional behavior assessment* Antecedent based intervention* Extinction* Response interruption/redirection* Differential reinforcement of alternative, incompatible or other behavior (DRO)* Functional communication training*

13 Social skills training* Peer mediated instruction Social narratives* Structured play group PECS

14 Visual supports* Discrete trial Naturalistic intervention Parent implemented intervention Pivotal response training Scripting Exercise*

15 Computer assisted, SGDs, smartphones, tablets* Video modeling*

16 Overview Goldilocks Rule Choices, choices, choices Sooner than later Catch them being good Anytime, Anyplace Less is more

17 Not too big, not too small, not too loud, not too bright; not too fast, not too slow, not too hard, but just right! Set the stage Just right fit Plan ahead Movement!

18 Visual Supports Visual schedules First/then boards Choice boards Token boards Timers Modeling Personal Narratives

19 Visual supports: High Tech First/Then ireward Choiceworks

20 Visual supports: Low Tech

21 Visual supports: Self-regulation

22 Visual supports: Self-regulation

23 A way to communicate without acting out AAC tools AAC strategies

24 Positive reinforcement Differential reinforcement Redirection Prompting Planned ignoring Extinction

25 Follow child s lead Every moment counts From start to finish Teachable moments within visits Model for families Preparation and recovery Anticipation Calm before the storm Calm after the storm

26 ABCs of behavior Antecedents, Behavior, & Consequences Your behavior matters! Time Delay Change your expectations Consider the client Self-regulation, Self-management physiological Model for the parent

28 Take one minute to identify one strategy/intervention you would use with this child

29 Goldilocks Rule Choices, choices, choices Sooner than later Catch them being good Anytime, Anyplace Less is more It s ALL about U!

30 Monica Dowling, PhD Douglene Jackson, PhD, OTR/L, LMT

31 AFIRM Team. (2015/2016). FPG Child Development Center, University of North Carolina:

32 Stopbreathethink.org BreatheThinkDo with Sesame Street KidConnect app (14+) Smiling Mind app

33 E-book: A Beginning Step to Using Functional Behavior Assessment and Behavior Intervention Plans (2008) Calm Down Book-drjepstein@southshorepsych.com Positive solutions for families: eight practical tips for parents of young children with challenging behavior SolutionsforFamilies.pdf

34 Bayat, Mojdeh. (2015). Addressing Challenging Behaviors and Mental Health Issues in Early Childhood. Council for Exceptional Children - Routledge Burge, P., Ouellette-Kuntz, H., Isaacs, B., & Lunsky, Y. (2008). Medical students views on training in intellectual disabilities. Canadian Family Physician, 54, ) Dababnah S. & Parish S.L. (2016). Incredible Years program tailored to parents of preschoolers with autism: pilot results. Research in Social Work Practice, 26, Emerson, E. (2013) Prevalence of psychiatric disorders in children and adolescents with and without intellectual disability. Journal of Intellectual Disability Research, 47, 51-58) Masse, J., McNeil, C., Wagner, S., and Quetsch, L. (2016). Examining the efficacy of parent-child interaction therapy with children on the autism spectrum. Journal of Child and Family Studies, 25, Odom, S.L. & Wong, C.I. (2015). Connecting the dots: supporting students with ASD. American Educator

35 Thompson, J.R., Bradley, V., Buntinx, W.H.E., Schalock, R.L., Shogran, K.A., Snell, M.E., Wehmeyer, M.L. et al. (2009). Conceptualizing supports and the support needs of people with intellectual disability. Intellectual and Developmental Disabilities, 47, Totsika, V.I., Hastings, R.P., Emerson, E., Lancaster, G.A., and Berridge, D.M. (2011). A population-based investigation of behavioural and emotional problems and maternal mental health: associations with autism spectrum disorder and intellectual disability. Journal of Child Psychology and Psychiatry, 52, doi: /j x. Weiss, J.A., Baker, J.K., & Butter, E.M. (2016). Mental health treatment for people with autism spectrum disorder (ASD): Fostering the mental health needs of people with ASD. Spotlight on Disability Newsletter, 8. Retrieved from Wong, C.I., Odom, S.L., Hume, K.A., Cox, A.W., Fettig, A., Kucharczyk, S., Brock, M.E., Plavnick, J.B., Fleury, V.P., and Schultz, T.R. (2015). Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review. Journal of Autism and Developmental Disorders, 45, doi: /s z

Uniqueness of Communication Deficits in ASD

Uniqueness of Communication Deficits in ASD State of the Science and Future Directions in Communication Interventions for People with ASD Jennifer B. Ganz, Ph.D., BCBA-D Texas A&M University Presented for: Thompson Center for Autism and Neurodevelopmental