Problem/challenging behaviors in students with multiple impairments

1. Problem/challenging behaviors in students with multiple impairments Dr Mira Tzvetkova-Arsova Sofia University “St. Kliment Ohridsky”

2. Behavior: • Behavior = something you observe, but not emotions. • New psychological and educational concepts on behaviors; • Now: almost every behavior has a communicative value and meaning; • We are dependent on social understandings, stigmas and values about appropriate and inappropriate behaviors. They often do not apply to multiply impaired students.

3. Please think what words fit the definition of behavior • Bad • Hit • Scream • Angry • Upset • Sit • Property destruction • Self injurious • Push and pull others

4. Some types of challenging behaviors: • Aggressive, • Self-injurious, • Stereotypic/self-stimulatory behavior, • Uncooperative, • Sudden change of moods (emotions go up and down), • Social/sex behaviors (masturbation, exhibitionism, fetishism etc.), • Obsessive-compulsive behaviors/rituals, • Phobias (fears), • Placement of objects in mouth etc.

5. The ABCs: • Antecedents: who, what, when, where happens before a behavior is demonstrated? • Behaviors • Consequences: reinforcers; punishment; ignorance, negative reinforcement.

6. Direct 10 steps in evaluating a behavior (Bernstein, 2000) • Define the behavior that is troublesome. Be very specific. Write it down strictly and correctly. • Observe the behavior in a longer period of time. Observe the ABCs: - Antecedents – events that come before the behavior; - Behavior – note the frequency, intensity, duration; - Consequences – what maintains the behavior (getting items or attention; avoiding or escaping from an unpleasant situation; self-stimulation; skill deficits…..)?

7. Continuing….. 3. Always do a functional analysis of behavior and make a guess why the individual is demonstrating the behavior. 4. Increase desirable behavior, other behavior or incompatible behavior using reinforces. • Choose a reinforcer: material, social, activity. • Follow the rules for reinforcers: immediate, frequent, individual, consistent. Always use specific praise. • Make sure the environment supports “good behavior”. Look at settings as antecedents; take unto account sensory impairments.

8. Continuing….. 8. Decrease undesirable behavior though using differential attention (praise and ignoring). Use signs, gestures, pictures, objects…. 9. Collect strict data to see of possible changes in behavior. Think of what possibly have changed the behavior; if there are no changes – adjust your plan. 10. Changing behavior takes time. Behavior often gets worse, before it gets better!

9. Reinforcers: • Types of reinforcers: - primary (comes immediately after a behavior) - secondary (comes later). Can be: material; activity; social.

10. Continuing…… 2. Using reinforcers: 2.1. Rules - immediate (cause effect) - frequent - individual - you don’t know about them until you try….

11. Continuing…… 2.2. Considerations when using reinforcers: - consider age and interests, - evaluate amount of behavior to earn reinforcer, - ask student what he/she would like, - be aware of satiation.

12. Continuing…… 2.3. How to use reinforcers: - define a behavior to increase, - select a reinforcer, - define a reinforcement schedule, - follow rules for giving reinforcement, - always use praise, - measure results, - make adjustments, - fade reinforcement slowly.

13. Advice: • Usually reinforcers work very well with most challenging behaviors. • However, they are not so useful with obsessive-compulsive behaviors (OCB), because they follow a curve. Often we can use reinforcers and they will work for a while, but later the behavior will be demonstrated again.

14. Activity: Please list things that may be reinforcing yourself: • Primary reinforcers: a) ………b) ……..c) …….. • Activity reinforcers: a) ………b) ……..c) …….. • Social reinforcers: a) ………b) ……..c) …….. • Material reinforcers: a) ………b) ……..c) …….

15. Main strategies for managing challenging behaviors • Treatment of medical reasons Appropriate medications. But as a result: apathy, tiredness, exhaustion, headache etc. • Removal of negative stimuli. If the problem behavior is caused by a specific stimulus – a person, a word, situation etc., it can be removed or eliminated. • Use of methods for reinforcement of positive and negative behaviors.

16. Increase/Reinforcement of positive behaviors 1.Contracts. • They should be precise. • They should plan appropriate for the student stimuli. • Once the contract is finalized, all parts should fulfill the duties accepted. 2. Awards. • They should be carefully planned and selected. 3. Modeling. • Taking a role-model – a parent, a friend, a singer or a movie-star, whose behavior the student copies and imitates.

17. Decreaseof challenging behaviors • Ignorance/extinction (only in cases when attention is looked for and desired). • Verbal punishments. • Time-out. • Satiation. • Punishments/taking away privileges. • Redirection (changing activities).

18. In conclusion: • When working with a student with challenging behavior – be patient, be positive, be optimistic, remember that often a behavior gets worse before changing to better, do not forget that challenging behaviors often change from one to another. • When analyzing and changing a challenging behavior, always work closely together with a psychologist.