Behavior Intervention Plan Target Behavior and Client Background Part 1

CLIENT: Sara F.
DOB: 05/17/2006
1. Client Background

Sara is a five year old female with no major medical problems. She lives at home with her mother, father, and two sisters. Sara attends a school for children with developmental disabilities. Sara attends school five days per week from 830 to 230. Her class is made up of 6 other students, one special education teacher and 2 to 3 aides. Sara has trouble with transitions both at school and in her home. Sara loves to go to school, but has trouble with the transitions throughout her day. Her parents have seen this in the home as well. Sara’s parents report that she will throw scream, cry, bite, kick climb on furniture and swipe items onto the floor Sara also will throw self onto the floor. This behavior occurs daily. It has also been witnessed by the parents the Sara become angry when she is asked to move to the next activity or tasks. The episodes will last from anywhere from 2 minute up to one hour. The staff at school did a recording of the episodes. The durations of the behavior and what prompted this behavior to happen. Sara parents want this behavior to stop, so they will start a plan at home as well. They feel that the behaviors are in the way of Sara ability to learn. At this time no major issues in the family or otherwise, no medications or treatments. In the past Sara had ear tubes put in for fluid buildup.

II. Operational Definition of the Target Behavior
Biting, screaming, crying, biting, kicking, climbing on furniture, swiping items on the floor and throwing herself onto floor, are the major issues during her school day.

Functional Behavior Assessment
III. Describe and Verify the Seriousness of the Problem
Sara’s target behavior of biting, screaming, crying ,biting, kicking, climbing on furniture, swiping items on the floor and throwing herself onto the floor was selected because on the welfare of self and others in the room. Her behavior has shown negative effects and negative behaviors in all other children in the class. Sara self-destruction behaviors cause harm to her and others, the assessment was done because of safety issues.
IV. Direct and Indirect Assessment Strategies
A. FAI;
The way that Sara was interviewed was by utilizing the Functional Assessment Interview questionnaire October 9, 2011 at 10am. What we found out is that Sara will begin these behaviors when, teacher directed activities were presented to her, or any group activity. Change in routine and transition from one task to another. Sara does not realize the seriousness to her tantrum’s, but does enjoy the reactions she has been receives from adults in the room. Sara does not like when a teacher tries to help her physical example: Sara holds her pencil the incorrect when, teacher puts fingers on hers to correct... Sara will begin one of her tantrums. What we are hoping for is for Sara to gain trust and achieve a more positive interaction between parents, peers and teachers.
B. The Functional Observation Form: ABC Recording Sheet
Behavior: Tantrums
Individual: Sara F.
Observer: Laura Kwiatkowski DATE | TIME | ANTECEDENT | BEHAVIOR | CONSEQUENCE | POSSIBLE FUNCTION | 10/9/11 | 10:10 | Puzzles with teacher time to go to bathroom | Running, throwing items off table Duration: 6 minutesFrequency: throws items from tables in room 3 different times | Ignore behavior watch she does not get hurt, redirect Go to bathroom and finish puzzle | escape | 10/9/11 | 11:00 | Sight wordsTime to move to next tasks | Runs, screamsDuration 8 minutes | Ignore behavior make sure doesn’t get hurt redirect when possible with replacement task or item | Sensory/escape | 10/10/11 | 9:00 | Coming into class room | Throws coat start runningDuration 1 minute | Sara is shown a picture text to hang up coat Picks up coat and hangs up | Transition from bus to classroom/possible escape from work | 10/10/11 | 10:15 | Time to walk to speech | Screams, runs, throws items from table Duration:3 minutes | Sara is told to line up, time for speech, teacher puts on I pad, if you do work first than reward(I pad) | Doesn’t like speech/ escape | 10/11/11 | 9:30 | Number ID | Throws cards on floor runs away Duration:15 minutes | Sara is told once come here time to work, no response; Sara is ignore teacher put on song and Sara comes running back and does work | escape | 10/12/11 | 9:45 | Fire drill | Bell goes off, Sara screams no! throws self on floorDuration:22 minutes | Teacher picks Sara off floor and shows picture card of fire drill | Loud noise and change in routine | 10/13/11 | 2:30 | Time to go home Sara engaged in a task she likes | Runs around room scream yells goes on tablesDuration:10 minutes | Put down on safe ground and reprimanded | Doesn’t want to leave task | 10/14/11 | 1:00 | Paly time after lunch over | Throws toys Duration:15 minutes | Continues throwing items until removed from class | Sensory/escape | 10/14/11 | 2:00 | Group work time | Throws items screams and runsDuration:20 minutes | Children left room until Sara settled down | Escape/to next activity | 10/15/11 | 11:00 | speech | Runs, jumps, screamsDuration 45 minutes | Doesn’t like to go to speech | escape | 10/15/11 | 2:45 | letters | Throws self on tableDuration:10 minutes | Changed activity | Escape/avoidance | 10/16/11 | 3:00 | Writing numbers | Throws self on floorDuration 6 minutes | Change activity | Escape/avoidance | 10/17/11 | 2:15 | Art project | Bites teacherRuns around roomDuration:3 minutes | Cutting isn’t a favor task | Escape/avoidance | | | | | | |

Sara was observed and monitored in several different settings and tasks. Sara was observed for 13 days. Sara had tantrums 13 times out of the 20 observational sessions. The durations of each tantrum was recorded and analyzed. Sara exhibited tantrums when demands were set upon her all during a transitional time. Each tantrum lasted one to forty-five minutes. Behavior seems to be an escape and/or avoidance to transitions.

C. FAST; The functional Assessment Screening Tool was used with Sara on October 9, 2011. Sara’s behaviors were most consistent with escape/avoidance of instructional demands, or when denied access to a preferred item. Parent’s denied any present health issues that would contribute to this behavior. High rate of reinforcement through highly preferred items appears the most applicable to Sara’s target behavior.
D. MAS
The motivational assessment scale was used for Sara to identify the function to Sara’s behaviors. Sara’s behavior appears most likely to occur during change or transitions and teacher directed activities.
V. Data Analysis of Assessment Information
See Competing Pathways
VI. Hypothesis Statement Regarding the Function of the Target Behavior
Sara will tantrum with any change and/or transitions.
VII. Identify the Functionally Equivalent Replacement Behavior (FERB) input and set Behavior Change Criteria/Change
Am A-B treatment plan design will be used. The teachers and aides will collect and record episodes, during transitions and changes in the room. The data will be taken for two weeks. Once k (a stage) baseline has been established in the first week, Sara will be rewarded with a choice of reinforce after every tantrum not shown after change or transition. (Week 2) Sara will be able to carrier a highly preferred reinforcement to and from activity.

Part III Behavior Intervention Plan
Antecedent Events: - Transitions -Teacher directed activities
Appropriate Teaching Strategies for the functionally equivalent replacement behavior (FERB): tantrums: 1. Subject will ill have access to many different reinforcements.
2. Teachers will delivery instructions at a high rate of reinforcement, to keep the subject from involving herself in bad behaviors. 3. Subject will be rewarded before the start of instructions for simple tasks. 4. Subject will work in a quiet location in the classroom and if a partition can be secured to receive 1:1 instructions in morning and afternoon while at school, which will qualify as antecedent strategies (prevention), for behaviors. 5. Subject will create a more individualized learning environment. 6. Revise instruction to build high rates of active student responding. 7. Teachers will take data on the start of inappropriate behavior and the ending time.

Levels of measurement and Data Collection strategies for the target behavior and the functionally, equivalent replacement behavior (FERB) 1. Subject’s teacher will take notes, data and times (Beginning and end of tantrums) of each episode. 2. Subjects teacher will take day for two weeks on every incident of tantrums during transitions. 3. Subjects teacher will take data when subject does not comply with intervention. 4. Data will be analyzed each day before going home. 5. The data recorded will be transferred to a spreadsheet every day and graphed at the end of each week.
Reinforcement Strategies and reinforcement Schedules 1. Minimize down time and transitions. 2. High rate of active student responding throughout the school day 3. Whenever possible avoid interfering with Sara need for sameness (for safety reasons) Strategies Consequences: Continue current strategy of blocking and redirection. Give minimal verbal attention to Sara during and immediately after problem behavior.
Note: once ecological factors are remediated a baseline frequency of problem behavior should be established before consequences strategies are reconsidered.

Identifies appropriate procedures for measuring inter-rater reliability of data collection system: Teacher will monitor her behavior during the treatment plan several times a week. Teachers will take notes of the date, start and end times of session and duration of tantrum.
Develops a comprehensive monitoring plan for implementation of the behavior intervention plan and data collection: Teachers and subject data will be compared at the end of each week. Further interventions will be considered after review of the data.

X. Intervention/Research Design and Level of Measurement The A-B research design will be implemented; one line graph will be done. The data plot will be on how many tantrums occur each day. The teacher will turn in the subject’s data and it will then be put into a spreadsheet. This will be done at the end of each week.

Final BIP
Literature Review
When dealing with tantrums and difficult behaviors in autism spectrum disorders, using behavioral approaches alone can sometimes fail. What we need to do is find the missing pieces. Before starting a behavioral program we need to look at the reasons behind the behavior. Most of the behavior stems from a request, seeking attention, sensory, or avoidance.
Children with autism have such a dramatic resistance to change or transition that it is difficult to get them to stop one activity and move to another. The reason may be that the child finds the transitions or activity difficult and/or uninteresting. The intervention should then be geared to reducing stress within and/or increasing the motivation for the activity.
Sandra Sinclair is a parent of a child with Autism. She is also the author of “Newly Diagnosed Autism Spectrum “- She states “Progress is made in small increments, but as time goes on, tantrums should decrease, and you may start to ask the child to contribute ideas about solving problems during the emotional moments”.

References
Autism Articles, http://www.autismvoice.com

XI. Graph Data and Develop a Narrative Analysis of the findings see attached
XII. Identify Generalization and Maintenance Strategies, Self-Management Strategies The basic strategy for promoting the child to generalize is to incorporate the setting so that the child will generalize. The greater the similarity between the instructional environment and the generalization environment, the more likely the target behaviors will be permitted in the generalization setting, (Cooper, John O, Heron, E. Timothy, Heward L. William Applied Behaviors Analysis second edition ) p. 632
We need to Include a program common stimuli, meaning we include features of the generalization setting into instructional settings. The procedures should be as close as possible to the real world. Van den Pol and colleagues (1981) programmed common stimuli when they taught three young adults with disabilities how to order food in the restaurants. The researchers use many photos and numerous items just like the items in the restaurants. You may also want not use community setting outings, not all students would benefit this at first. Third would be teaching in the natural setting and last make the environment as safe as can be. Target behaviors are sometimes dangerous and we cannot place any child with bad behaviors in an unsafe environment.
Teaching loosely would be the choice her with Sara. Follow teacher directions, teach in different places in the school, vary your tone of voice, vary your choice of words, vary reinforcements, teach in both quiet and loud environments, teach from different positions, and use facial expressions.

Hypothesis; regarding the function of problem behavior, this hypothesis is based on direct observation and teacher reports. 1. Escape/Avoid unwanted activity 2. Access to tangible item or activity 3. Adult Attention-for example, Sara may push materials to the floor and leave the table and climb on the classroom tables. When a teacher approaches Sara will run away, look back and giggle. It appears that she likes to be chased around the classroom by an adult (attention).
Recommended Behavior Intervention Plan
1. Teach Sara to follow simple 1-step directions (basic instructional control) Initial Targets; “sit down”, “line up”, “look at me”, “come here”. Teaching Method 1-on-1 Direct Teaching in separate location with minimal distraction, Materials needed: token board, tokens, data collection sheets, chairs, reinforce menu. Token Board a laminated piece of paper (for equivalent) with pieces of Velcro to which tokens can be affixed Tokens should be simple and standard. In others words, fancy tokens of various colors, shapes or size should not be used. Plain and simple are preferred. Tokens should be standard size and round. Reinforce menu should be laminated and have pictures of preferred items/activity, Teaching Procedure: “Sit down” (Sara is standing up within 3ft of a chair; teacher sitting or standing near the chair Antecedent-Teacher says “Sara sit down” Response- Sara sits down Consequence-Teacher reinforces response (See below)
“Line up” Sara is standing 10 ft. away or sitting of the door Antecedent; Teacher says “Sara “lineup” Response- Sara walks to and stands by the door Consequence- Teacher reinforces response (See below)
For” look at me”, the antecedent is teacher says look at me, response is Sara looks for 1 second, the consequence is the teacher reinforces the response see below. “ Come Here” Sara is sitting at the table within 5 feet of teacher--- antecedent-- teacher says “Sara come here”, response Sara approaches the teacher, consequence teacher rein forcers (see below)
Response Reinforcement; specific praise plus physical attention, + token. Every correct response should be followed by specific verbal praise. + Physical attention (e.g. high 5, hug, hug, tickle) and the delivery of a token that can be affixed to the token board.
Access to tangible/activity; after every 4 correct responses (when there are 4 tokens on the token board) Sara should be given brief (15-20 seconds) access to a preferred tangible item or activity. Example includes favorite toys, books, bouncing on a ball. Or a small treat (a piece of popcorn, a mini Oreo. Etc.).
Please note: Sara will “exchange” the 4 tokens for the opportunity to choose from an array of 3 or 4 preferred items/activities. In addition, Sara should be prompted to verbally request the item (or say” yes/no” when a choice is offered). If she does not do so independently (e. g, “^I want {item}
Since observation suggests that physical prompting might precipitate problem behavior, no correction should be given at this time. Instead simply record a minus (“-“) on the data collection sheet and move on to the targeted direction.
Data Collection: tally correct and incorrect responses on a data sheet, graphing; a visual learning picture can be helpful with respect to analyzing problems with skill acquisition, should such problems arise. Frequency of teaching, the data collection sheet will be set up with blocks of 20 (5 opportunities for each of the initial 4 target directions). Completing 1 block of 20 responses should take no more than 10 minutes. It’s suggested that Sara engage in this learning activity 3 times per day at different times of the day. Criteria for initial success, at least 90% (18/20 responses correct per block) for two consecutive days (4 to 6 consecutive blocks).
Above are some ways in which Sara can be taught to partake as much as possible in managing her behavior.
The goal here is to have zero tantrums during transitions and any teacher directed tasks.

REFERENCES
Cooper, O. John, Heron E. Timothy, Herward, L. William Applied Behavior Analysis, second edition