Positive Behavior Support in Inclusion. Taylor Singleton, CTRS and Eric Rueger OPRA Conference February 4, 2019

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Positive Behavior Support in Inclusion Taylor Singleton, CTRS and Eric Rueger OPRA Conference February 4, 2019

Learning Outcomes Participants will be able to list a strategy for each of the 4 types of behavior. Participants will be able to complete an ABC behavior observation form. Participants will be able to assess direct threat of aggressive behavior.

CRC-TR s Behavior Policy The Cincinnati Recreation Commission strives to maintain a safe, positive atmosphere in all programs and facilities. Participants are expected to treat others with respect and to abide by all Recreation Commission rules of conduct. Recreation Commission staff members will promote positive behavior and implement various strategies designed to minimize the need for disciplinary action. This includes clarifying behavioral expectations and reinforcing positive behavior. When disciplinary action is necessary, it will be applied in a consistent manner with consequences appropriate to the level of behavior.

Disciplinary Techniques: Inappropriate and Strictly Prohibited Corporal (physical) punishment Locking or confining participant in an enclosed area Deliberately humiliating, intimidating, or verbally abusing participant Withholding food, drink, or bathroom usage Having another participant apply the discipline The use of physical restraints Staff with current CPI certification may use the techniques they are certified to perform

CRC-TR s Positive Behavior Support Philosophy Most negative behavior can be eliminated through structuring the program environment. Negative behavior will be addressed immediately in a consistent manner (unless attention seeking, and this will depend on the participant). Behavior which continues to occur despite a well structured environment shall be addressed through Behavior Support Plans.

What do we mean by Behavior? How we act Communication Underlying cause Learned Serves purpose Aggressive Socially Inappropriate Physical Verbal

It s Not What You Say. It s How You Say It. Be creative! Always try various ways of making a request until the participant can repeat the request to you or physically begins to do the task. Don t get frustrated! We all learn differently and some people have a more difficult time with verbal directions. Never assume that someone understands your directions or request.

ABC s of Behavior Antecedent Behavior Consequence Form/Practice

Environment Promoting Positive Participation The following are simple ways to maintain control at your programs while providing a valuable service to all participants: Understanding-participants have different needs that need to be met Anticipating-where might issues arise, how will they be addressed Planning-know what the plan is all the way through Structuring-know what you are doing, when you are doing it, and how it will be done and communicate Managing-manage the different things as they arise

Understanding: Know Your Participants What do they like? What do they dislike? How do they communicate? What situations cause fear and anxiety? What activities, items, people, etc. can be used as positive reinforcement? What issues have they had in the past? What staff are they most comfortable with? How do they manage behavior at home or school?

Understanding: Discipline vs Punishment PUNISHMENT Tells the learner what NOT to do DISCIPLINE Tells the learner what you want them to do This is like the difference between: Shut up and Please Listen Don t Run and Walk

Understanding: Punishment vs. Consequence Punishment is suffering, pain, or loss that serves as retribution. Consequence is something produced by a cause or necessarily following from a set of conditions. We use consequences- positive and negative. Examples of positive consequences? Examples of negative consequences?

Understanding: Positive Behavior Take every opportunity to give praise for positive interactions Give each participant praise at least one time during each program meeting Use the positive reinforcement knowledge you have on the participants to your advantage

Understanding Reward vs Reinforcement Reward Examples Reinforcement Examples

Understanding: Function vs Form Function: Reason or purpose of the communicative behavior Examples: Form: Behavior used to communicate Examples:

Understanding: The 4 Main Functions of Behavior Attention Please pay attention to me. Escape/Avoid I don t want to. Tangible I want. Sensory I am bored, frustrated, hurt, scared, uncomfortable, or I feel better when I.

Un-medicated Mental Illness Unpredictable Communicate with Family Set limits Document the behavior

Anticipation: Be Alert and One Step Ahead Staff must always be alert to potential problems Observations Provide close supervision at all times Intervene early Removal... Toy Participant

Anticipation: How to Avoid Power Struggles Remain Calm. Don t over react. Model appropriate behavior at all times. A power struggle requires TWO people. Try to avoid the power struggle, win/win vs. win/lose. Save Face. Try to not single out or humiliate camper. Disengage. Ignore minor behaviors and pick your battles, when necessary use a matter of fact and non-confrontational manner.

Anticipation: How to Avoid Power Struggles Deflect Camper s Attention Refocus through ignoring and redirection. Ask camper how the problem can be resolved and ask them to be a part of the solution. Chillax Time Let the camper chill out in a safe place. Remind them that when they are ready you will be ready to discuss it. Wait De-escalation of emotion coupled with unconditional positive regard. Up, Down, Up. Example: You were doing a good job painting. I know you got mad and threw your paint brush. I am proud of you for calming down and coming back to the group.

Planning: Plan Activities to match Interests, Skills, and Energy Multiple activities may be needed for each activity period due to the wide range in skills and interests It may be necessary to change activities more frequently to maintain interest Plan additional activities in case an activity is not successful ALWAYS have a back up plan Plan activities with multiple parts; move on to other parts when participant is finished, bored, etc.

Planning: Prepare Participants for Transitions Give at least 5 minutes warning before ending an activity 5 Minute Hand Continuously tell them how much time is left, Elliott, there is 3 more minutes to cut with scissors Tell them what comes next Matthew, 4 more minutes then its time to change our clothes Explain what you expect before having participants move locations

Structure: Establish Rules Establish a few clear (easily understood) rules for behavior If possible, post rules in a visible location Review rules with participants daily Provide frequent reminders of rules, especially during transitions Clarify expectations before starting an activity

Structure: Predictable Routine Try to stay as consistent as possible with the order in which an activity should be done Each camper will have an individual schedule of the amount of time they should spend with each afternoon activity If possible, post a visual schedule Only if you plan to stick to it!! Prepare participants for any changes to the routine ahead of time If you know next week that the pool will be closed talk about it ahead of time to prepare

Structure: What are Routines? Components of Routines: Beginning and end Outcome oriented Meaningful Predictable Sequential/Systematic Repetitious

Structure: Visual Supports Examples of Visuals Schedules PECS Visual Cookbooks Schedules Priming/Prompting

Structure: Social Stories Examples of Social Stories When do we need these? How do they work?

Managing: Setting Limits Explain exactly which behavior is inappropriate (clearly and briefly) Explain why the behavior is inappropriate (clearly and briefly), explain appropriate behavior Give the participant a reasonable choice (do what I ask, or specific consequence) Allow a little time to think it over (encourage making right choice) Enforce consequences (follow through every time)

Managing: Redirect Inappropriate Behavior When possible use a matter-of-fact tone Have something interesting to redirect to Be consistent, do not make threats and not follow through ALWAYS follow through with consequences Use natural consequences that match the behavior Consequences should be immediate to the actual behavior (cause and effect) Consequences should be progressive from least severe to more severe

Managing: ATTENTION seeking Give increased attention (every 3-5 minutes), positively interact when the participant is okay Reinforce more desirable behavior with positive comments (Charlie, I like the way you helped Chris with his heavy back pack today) Minimize attention for inappropriate behavior (less eye contact and verbal input) Planned ignore (walk away if possible) Teach ways for participant to ask or indicate need for attention in a positive manner

Managing: ESCAPE/AVOIDANCE Minimize demands, make only necessary ones Phrase as directives, not orders or questions Do not ask participant to do something unless there is an option to say, no Use verbal counseling skills such as, I know you don t like this but. Offer positive reinforcement upon completion of an activity Use First Then board Sandwich disliked activities between two liked activities Offer choices this equals self control (you will know which participants you can do this with, does not work for all) Do NOT force the issue Suggest participant do one more and then quickly end the activity Teach child appropriate way to end an activity or take a break

Managing: TANGIBLE seeking Respond to needs BEFORE the negative behavior happens Encourage choice-making opportunities throughout the day Teach participant how to wait Teach participant to be independent and to meet their own needs Teach participant an appropriate way to request wants, needs, and desires

Managing: SENSORY seeking Provide verbal counseling if fear-based Enrich environment to decrease boredom Increase positive attention/interaction (every 5-10 minutes) Find ways to give child same effect but in a more acceptable way Require completion of activity prior to engagement in sensory behavior Teach participant self-calming strategies

Managing: Documentation Incident with staff or/and participants Examples Why is this important Verbal warnings Specifics Actions taken

Managing: Behavior Support Plans Behavior Support Plans are necessary: When the behavior is aggressive and can cause harm to participant or others When the strategies do not decrease their duration, intensity, or amount

Direct Threat/Removal

Managing: What to do in a Crisis Stay calm Keep talking to a minimum Try to redirect to another task Remove from environment to a quiet place Remove other participants from the environment Remove or prevent access to harmful items Wait for the episode to pass Use CPI model and training

Questions? Contact Information Eric.Rueger@Cincinnati-OH.gov Taylor.Singleton@Cincinnati-OH.gov Kristen.Riggins@Cincinnati-OH.gov