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Behavioral Strategies Training

Kimberly Ball Davis - Friendswood ISD (Gen Ed)
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Kimberly Davis

on 18 August 2016

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Transcript of Behavioral Strategies Training

AutismSpectrum Disorders -
Learning that our students are not from outerspace

FOCUS
SEARCHING
Assessment
Strategies

Characteristics of ASD
UNDERSTANDING
Symptoms of ASD

OK, but what IS ASD?
*ASD originates in the brain
*Nuero-develpment brain-based disorder
*Affects social interaction, verbal and nonverbal communication and repetitive behaviors.
*Can be diagnosed by the age of 2, but often times, symptoms of autism can be seen as early as 6-8 months.
Effective Reinforcement
Listen
Do you know the financial costs of ASD?
Be Proctive
Identify Procedure and Function

Jon gets out of his seat and wanders around the classroom every time his teacher is working with another student. His teacher uses verbal prompts to get Jon to return to his seat. He will remain in his seat and complete his work if his teacher provides repeated verbal prompts until the task is completed.

Procedure=
Function=
Each time the child is at the pediatrician, from birth to 36 months, there should be a screening for developmental milestones. Diagnosis is most often based on the criteria in the DSM-V.

There are a number of professionals who can confirm the diagnosis. (Always make sure you are working with an experienced professional.)
-Pediatrician
-Psychologists
-Neurologist
-Psychiatrists

Early diagnosis is so very important because early intervention has proven to be the most effective.

This does not mean that if you have a student in your classroom who is exhibiting signs, that he does not have autism. Sometimes, as children get older, social and/or academic deficits become more evident and the you may wish to talk to your Licensed Specialist in School Psychology about your concerns.
For school purposes, there is a difference between diagnosis and eligibility. The Individuals with Disabilities Education Act (IDEA) requires that public schools provide assessment, free of cost, to determine eligibility for services through the school. Assessment is made by an interdisciplinary team working together to determine eligibility in determining disability that affects communication and social interaction.
Discussion of Augmentative and alternative communication (AAC):

What are AAC's?

They are systems that can be aided or unaided to help students who can't use verbal speech communicate with others. Some types of ACC include gestures, sign language, picture symbols, and speech generating devices.
RRB's are often reported as the most difficult for teachers to manage because of their interference with daily activities. And, unfortunately, they make it difficult for socialization with their peers and even adults. They often impede the learning process at school and home.
K - W - L / Autism
Facts on
Autism Spectrum Disorder.
Autism Spectrum Disorder is a new name given to autism, aspergers, pervasive developmental disorder, and childhood disintegrative disorder. There is not any delineation of disorders since the new DSM-5 came out in 2013. ASD is the scientific consensus that now encompasses all of the disorders. It affects one in 68 children. This reflects an increase of 10-17% increase in diagnoses and surprisingly 1 in 42 boys as compared to 1 in 189 girls. Although some of the reason for the increase is due to awareness and new screening procedures, the growing number cannot all be attributed to this.

Positive Reinforcement:
Positive in the sense that something is added to the environment. Procedure is that desired stimuli are presented to a person after a behavior.
Examples????
Positive reinforcement increases behavior. People are more likely to repeat a behavior that has been positively reinforced.

Licensed for Creative Commons
Attibution Non-Commercial Share Alike
*Family cost a year - $60,000 - $80,000
*Added cost in healthcare and education per family - $17,000 (largest part of this was education cost, then healthcare)
*National cost for healthcare and education - exceeded 11.5 billion in 2011
*National cost of ASD care per year - 137 billion (majority of this in adult life)
*Average lifetime cost per person per year - 2.0 million
*Interestingly, mothers who have ASD children make 54% less than their counterparts.
Are you still asking why early intervention is SO important?


Effective early intervention can clearly pay for itself as well as better the lives of those living with ASD and their families.
Social Deficits?
Punishment:
Type 1 Punishment
Type 2 Punishment
Type 2 - Negative Punishment
This is why we do what we do!
Extinction and Planned Ignoring
Identify Procedure and Function:

Tommy's teacher never says anything to Tommy when he turns his work in on time. One day Tommy turned his work in late. His teacher lectured him on the importance of turning in his work on time. Now Tommy always turns in his work late and his teacher lectures him on the importance of turning in his work on time.

Procedure=
Function=
Have you seen the pink lights in my room?
Another intervention could involve sensory integration therapy.
The use of sensory integration therapy involves the stimulation of the sensory system. If the students nervous system can be stimulated through regulated procedures, there may less need for the self stimulation. Activities affecting the vestibular system like swinging, spinning, hanging upside down involve the head moving in different ways and can stimulate the vestibular system. Sight and sound can also be used. Some children are stimulated by bright colors, and long straight lines are often preferred. Back to those pink lights. Bright lights are often difficult for our students to manage. Having soft light may help with the student being OVER stimulated and then using a stimming behavior to modulate his environment. Sound is the same principle. Loud sounds are often aversive and the student begins stimming. Soft sounds used or soft music may help.
What to you find that most
frustrates your student?

I find that my students are most frustrated when they are not able to express their wants and needs. AAC's are effective in helping students facilitate their communication regardless of any cognitive, behavioral, or language deficits.

So many ASD students can benefit from augmentative communication tools and strategies.

"According to Krumboltz, career counseling should not end when a person has decided on a course of action. Rather, the person will need to look for a job, perhaps experience rejection, deal with positive and negative aspects of a job, and have to deal with new unforeseen proplems and possible crises that may arise following through on a plan of cation. Krumboltz believes that it is the counselor's role to help the individual take action, as well as decide on a course of action." (Sharf, 2010)
Medication
If the students' medical provider believes the RRB's are a result of a neurological or chemical imbalance, the use of medications may be effective. Similarly, if anxiety is the is the cause of the RBB's, medication is precribed to control the RRB's. The most commonly prescribed medications are the selective serotonin reuptake inhibitors (SSRIs). The use of medication alone is not preferred. Medication combined with the use of ABA behavioral modification interventions and sensory integration is preferred.
The ranges vary....many of you may have worked with kids on both ends of the disorder.
What degrees of ASD of have you witnessed at school?
The fictional character, Max, is diagnosed with ASD and we see a range of behaviors.
Reinforcement ALWAYS increases the rate of the behavior.
Emma yells and screams every day during math. One day Pam gave her candy and she stopped yelling and screaming. Now Pam gives her candy everyday during math.

A =
B =
C =
Procedure =




* DISC
-Deprivation
-how long has it been
-Immediacy
-3 seconds
-Size
-the amount mush be worth the effort
-Contingent
-only available when the desired behavior occurs
Do you see social deficits with ASD children in your classroom?
Children with social deficits may have:
Difficulties understanding the facial expressions of others
Difficulties with or complete lack of initiating social interactions with others

Lack of responding to social initiations made by others
Lack of responding to the emotions of others
Deficits in showing
Lack of interest in other children

Absence of or limited use of gestures such as pointing to share enjoyment with others

Absence of or limited imitation skills

Lack of friendship seeking behavior


Research has also shown that the social interactions of individuals with autism are significantly different from those with other developmental disabilities like Down syndrome. Individuals with autism have been found to be less likely than those with other developmental disabilities to orient to social stimuli, to respond to the social bids of others, and to initiate social interactions with others (joint attention.)
(Constantino & Todd, 2003)
autism-help.org
autism-help.org
May stimulate brain development
Supports functional spontaneous communication
Facilitates access to social information
Facilitates inclusion at home, school, and community
Facilitates greater independence in the home, school, and community
Facilitates access to literacy experiences
Preempts the need to develop aberrant communicative behaviors (reduces meltdowns)
Provides voice and ears to people with autism, including psychological benefits of better understanding others and being understood
Facilitates an improved sense of self concept due to greater independence and fewer outbursts
Why do you think this is?
Types of AAC's include no tech, low tech, mid tech, and high tech.

No tech: does not require a power resource (uses body gestures, etc.)

Low tech: power source and easy to use without training (like PECS - picture exchange system)

Mid tech: power source and requires some training

High tech: power source, expensive and requires extensive training.

The last three can have digitized speech (more natural sounding) and synthesized speech.
Cafiero, J., Meaningful Exchanges for People with Autism
Califero, J., Meaningful Exchanges for People with Autism
Assessment for Autism
As soon parents feel there might be something different, they should discuss their concerns with their pediatrician. Some of these concerns would include their child failing to make eye contact with them, repetitive movements with their body or toys, and not responding to their name. The Modified Checklist of Autism in Toddlers (M-CHAT) can be taken online at http://www.autismspeaks.org/what-autism/diagnosis/screen-your-child. The tool may guide you in being able to make a decision if you should refer to a professional.
Autism Speaks, 2014
www.gvsu.edu
Private Sector Public School
www.gvsu.edu
http://www.cdc.gov/ncbddd/autism/hcp-screening.html
Screening tools are meant to be a tool in the diagnosis process. It should be understood that the tools are just the beginning part of the assessment. It the tool indicates any deficits, then a full assessment should be administered.

Choosing the correct screening tool should consist of; considering the needs of the student, what types of delays are you trying to determine, the psychometric properties of the test (it does and measures what it says it will), setting in which the screening will be administered.
If a screening indicates a deficit, a professional will choose a diagnostic tool in the same manner as choosing the screening tool.

Diagnosis should not be made upon the determination of one screening tool. These tools usually use two or more sources of information to receive information from, like parents or caregivers information about their child and then it is combined with professional observations of the student.


Diagnostic Tools
• Autism Diagnosis Interview: Revised
(ADI-R) A clinical diagnostic instrument for assessing autism in children and adults. The instrument focuses on behavior in three main areas: reciprocal social interaction; communication and language; and restricted and repetitive, stereotyped interests and behaviors. The ADI-R is appropriate for children and adults with mental ages about 18 months and above.
• Childhood Autism Rating Scale (CARS): Brief assessment suitable for use with any child over 2 years of age. CARS includes items drawn from five prominent systems for diagnosing autism; each item covers a particular characteristic, ability, or behavior.
Centers for Disease Control, Autism.
Center for Disease Control, Autism. http://www.cdc.gov/ncbddd/autism/hcp-screening.html
• Autism Diagnostic Observation Schedule – Generic (ADOS-G): A semi-structured, standardized assessment of social interaction, communication, play, and imaginative use of materials for individuals suspected of having ASDs. The observational schedule consists of four 30-minute modules, each designed to be administered to different individuals according to their level of expressive language.
Center for Disease Control, Autism. http://www.cdc.gov/ncbddd/autism/hcp-screening.html
Center for Disease Control, Autism. http://www.cdc.gov/ncbddd/autism/hcp-screening.html
Gilliam Autism Rating Scale – Second Edition (GARS-2): Assists teachers, parents, and clinicians in identifying and diagnosing autism in individuals ages 3 through 22. It also helps estimate the severity of the child’s disorder.
Autism Treatment Evaluation Checklist (ATEC):
The Autism Research Institute (ARI) has developed this simple Internet scoring instrument (containing 77 items) that provides subscale scores and a summary score. Although designed to evaluate the effectiveness of treatments for autism, it may also prove useful for screening and diagnosis in children ages 5-12. Since the ATEC is a simple one-page form that can be copied freely and scored immediately (currently at no cost), it might be very useful as a diagnostic tool.

Example of Autism Treatment Evaluation Checklist-
Lets pick a student a fill out the checklist.
Whatever screenings or tools that are used, remember in the public schools, the interdisciplinary team will make the diagnosis. Diagnosis' should be made only by trained clinicians after complete evaluations of the student or child.

ABA
What is ABA?
ABA is the utilization of behavioral strategies that target individual behaviors of people with ASD. Through the use of ABA, target skills are identified and then learned over time until the skill in acquired and can be used in the natural setting. Deficit skills are also identified and through the use of behavioral strategies in ABA, these maladaptive behaviors can be reduced. Although there is not one ABA "program," there are several components that make ABA treatment productive.
Say that again....
Autism Speaks Autism Treamentnetwork
ABA applies the principles of behaviorism to make meaningful changes in the lives of individuals.
How would I implement ABA in the classroom?
You, as the teacher, need to define the students IEP goals by evaluating what the student needs to work on most, and according to his appropriate TEKS. The goals must be measurable and observable. The teacher must then implement the goals using evidence-based behavioral methods and then collect data to determine if the intervention was effective.
Leach, D., (2010). Bringing Evidence Based Practices into the Inclusion Classroom
Leach, D., (2010). Bringing Evidence Based Practices into the Inclusion Classroom

Terms and procedures teachers should be familiar with, within a ABA program.
An approach to learning that uses corresponding rewards and punishments that are linked to behaviors. Learning occurs by making association between the behavior and either the rewards or punishments for that behavior.
Operant Learning
Often known as the ABC chart (antecedent, behavior, consequent). It is a three-part model that says behavior is learned and influence by antecedents and consequence.
The three-term contingency
Antecedents are our cues for behavior. They are the events (the who, what, and where) that occur immediately before a behavior

Antecedents
Consequence
Consequent events are events that typically follow behavior and are necessarily viewed by the child as contingent upon behavior.The presence or absence of events after the behavior makes it
more or less likely that a behavior will happen more or less frequently.

Establishing operations have a value altering (momentarily alters the effectiveness of reinforcers/punishers) and behavior altering effects (momentarily evokes or abates behavior).
Establishing Operations
The process of breaking down a complex task
into its smaller steps or components. Tasks with many steps or components may be divided into phases for teaching purposes
Task Analysis
Is a one-to-one instructional approach used to teach skills in a planned, controlled, and systematic manner. DTT is used when a learner needs to learn a skill best taught in small repeated steps.Each trial or teaching opportunity has a definite beginning and end, thus the descriptor discrete trial
Discrete trial training (DTT)
http://autismpdc.fpg.unc.e du/content/discrete-trial-training-0
Is the current level that a target behavior occurs prior to intervention. It is absolutely essential to obtain baseline information prior to the onset of an intervention. It is only with measure prior to an intervention compared to data collected after the intervention begins, that the effectiveness of the intervention can be determined
Mouzakitis, 2007
Baseline
Is when something that has already been earned gets removed. You can think of it as a tax on behavior. Response cost is a type of punishment; therefore in order for a response cost procedure to be effective, the target behavior must decrease the future probability of occurrence. If the rate of behavior goes up or remains unchanged after wards, then it is not by definition a response cost.
Potterfield, 2013
Response Cost
EIBI is designed to work with young children in intensive settings using behavioral principles. EIBI involves a high intensity (number of hours as well as reliability) of intervention. EIBI can include discrete trial teaching, natural language teaching, social stories, video modeling, as well as other types of ABA-based strategies.
Early Intensive Behavior Intervention (EIBI)
Autism Speaks, 2013
ABA therapies are:
Structured
Collect data for target skills or behavior
Provide positive strategies for changing responses and behavior

Autism Speaks Autism Treatmentnetwork
What Therapies are Based on
ABA Principles?
Antecedent-based interventions
Computer aided instruction
Differential reinforcement
Discrete trial training
Extinction
Functional behavior assessment
Functional communication training
Naturalistic interventions
Parent-implemented intervention
Peer-mediated instruction/intervention
Picture Exchange Communication System
Pivotal response training
Prompting
Reinforcement
Response interruption
Self-management
Social narratives
Social skills training groups
Speech generating devices
Structured work systems
Task analysis
Time delay
Video modeling
Visual supports
All of these therapies are structured, some highly structured, they require data to be taken to measure growth in target skills, goals, and behaviors, and they provide strategies for changing responses and behaviors. ABA focuses on positive reinforcement strategies. These therapies can help students who are having difficulty learning or acquiring new skills, or behavioral difficulties.

There are several ways ABA can be implemented in
the classroom.
8. Communicate with the student’s parents. Parents are a great source of information about their own children. As members of the IEP team they are likely to have a multitude of suggestions for what would benefit their child with an emotional disturbance in school. They can also keep you informed as to events and developments in the child’s life, new medications or treatments, and how these might affect the student in school.
Common Factors that can lead to
Inappropriate Behaviors:
Autism:
Unstructured activities
Transitions
Writing demands
Social demands
Novel events or unexpected changes

ED:
Unfacilitated peer interactions
Unstructured activities
Interaction with authoritative adult
Asked to wait or told no
Demands placed
Transitions
Writing demands
Autism Treatment Autism Network
Reaching All Students:
Vary your delivery
Modulate your voice
Use a voice level that can be heard easily in the back of the room
Be very animated in your delivery, using facial expressions and body language
Move around

Autism Speaks Autism Treatmentnetwork
Can we modify behavior?


The Texas Statewide Leadership for Autism states that a significant amount of research supports the use of discrete trial training with individuals with autism (AU) in a variety of settings, including the school setting. Discrete trial training can help ASD students compensate for the challenges they face. Some of the benefits are:
The most important thing that separates behavior modification in special education from our attempts in everyday life to modify behavior is perhaps highlighted by the difference between research, or empirically based behavior change techniques that we feel comfortable putting in an IEP, versus going on a gut feeling. Which, by the way, leads very nicely into our definition of behavior modification.
• Important Characteristics of Behavior Modification (The Musts)...
•1. There is a strong emphasis on defining problems in terms of behavior that can be measured in some way.
2. The treatment techniques are ways of altering an individual's current environment to help that individual function more fully.
3. The methods and rationales can be described precisely.
4. The techniques are often applied in everyday life.


Applied Behavior Analysis and Functional Behavior Assessments

As was indicated previously, many of the techniques in behavior modification are attached to applied behavior analysis (ABA) principles. Discussions of ABA in schools, particularly in special education circles, generally cause educators to think of one thing- functional behavior assessments.
In essence, applied behavior analysis involves assessing the relationship between a behavior in question and the environment, and then enacting a change in the environment in the hopes of spurring a change in the behavior. A functional behavior assessment in special education is an evaluation conducted by professionals in a school which is designed to figure out what a behavior is the function of. In other words, what is causing a particular behavior to occur. Only then can appropriate interventions be decided on.

Given how common ASD and mental health disorders actually are, it’s likely that you may have a student or two with an emotional disturbance in your classroom. How do you best help them, support their learning, and encourage their well-being?
Synapse
5. Set clear behavioral rules and expectations for the entire class. Students with emotional disturbances and ASD are frequently the targets (rather than the initiators) of other students’ misbehaviors. Having a stated, explicit classroom management plan provides a solid structure by which both teacher and students can address inappropriate behavior, understand consequences, and develop a shared approach to behavior in class and toward one another.
6 | Provide accommodations. The student’s individualized education program (IEP) will spell out what accommodations the student is to receive in class and during testing. If you’re not part of the team that develops the student’s IEP, ask for a copy of this important document. Also check with your school district for guidance on local policy and appropriate classroom accommodations for students with emotional disorders.
Although accommodations will vary depending on the nature of the student’s emotional disturbance, often the appropriate accommodations will address:

side effects of medication
behavioral unpredictability
impairments in concentration and memory
4. Support the student’s inclusion. Emotional disturbances and ASD, by their very nature, can make it difficult for people to build or maintain satisfactory interpersonal relationships. You can support the student with an emotional disturbance in subtle but meaningful ways, especially during group work, cooperative learning activities, peer interactions, and team projects. There may also be times to let the student work alone, take a break, or have a hall pass for some quiet time apart.


All of these components of ABA, provide students with the learning opportunities to learning and communication skills. Students are able to improve attention, focus, follow directions, improve social skills and academics, as well as have a reduction in their maladaptive behaviors. One important difference of ABA and other therapies is the fact that the American Psychological Association and the US Surgeon General consider it a best practice and evidence based. This indicates that the methods of ABA have been proven effective through scientific tests of its usefulness and quality.
7. Join the student’s IEP team and help shape his or her special education program. As a team member, you can make sure the IEP includes accommodations and classroom adaptations appropriate to the student’s needs and success in your class. You can also advocate for program modifications and supports for yourself, to help you support this student in class.
Are there other interventions in
treating ASD?
Yes, of course, but as we just discussed, ABA therapies have proven to be most effective.

That is not to say that other interventions are not effective.

Many of these models have some components of ABA in them, but do not include all of them.
Basic Principles of ABA
*Environment
*Stimulus
*Antecedents
*Behavior
*Response
*Consequence
ABA is concerned with the analysis and changing of behaviors with the goal to identify target behaviors, select interventions, and evaluate effectiveness.
*Behavioral Interventions are Precise:
Behavioral interventions have measurable outcomes, such as the change in the frequency of a behavior.

*Behavioral Interventions Facilitate Empowerment:
When done correctly, do not seek to control people. Instead they enable individuals to exert more control over their environment and their own behavior.

*Behavioral Treatments are Collaborative:
Interventions are developed to through collaboration to identify goals, target behaviors and methods of change.

Many aspects of ABA involves the
use of Contingencies:
A contingency is a relationship between a behavior and a consequence, in which the consequence is presented if, and only if the response occurs.

Contingencies can be described in the form of if-then statements.

A contingency might either be a desirable stimulus or aversive stimulus. They may be applied to a person after a behavior or taken away.

Examples of
Desirable Stimulus?
Three Term Contingency / A-B-C

Antecedent = an environmental or physiological stimulus that precedes a behavior (also called a discriminative stimulus)


Behavior = (also called a response) is the target behavior of interest, anything the person does


Consequence = an event that follows the behavior




Sensory Integration (SI) is designed to identify disruptions in the way the student processes movement, touch, smell, sight and sound. Through SI the students is taught to process their senses in a more productive way. It can help the students with transitions, behaviors, and be able to tolerate things the student finds aversive. Many times it is used along with OT.
These therapies are very helpful in treating aspects of ASD and can be used in conjunction with ABA therapies, but they would not be effective as stand-alone interventions.
Another intervention is the psychopharmacological intervention for ASD. While there is no cure for ASD, there are common features of associated with ASD, that can be treated with medicine.
Medicines can be use to treat some of these disorders common with ASD include:
seizure disorders
attention deficit hyperactivity disorder
depression
sleep disturbances
behavioral disorders
Medications that have been approved for irritability and aggression are Risperidone (ages 5 and up) and Aripiprazole (ages 6 and up).

Side effects for atypical antipsychotics include:
weight gain
sedation
elevated triglycerides
insulin resistance
elevated prolactin (especially risperidone)
prolonged QTc interval
ADHD symptoms can be managed through the use of several medications.

Methylphenidates (ages 6 and up) include:
Ritalin and Ritalan SR
Concerta
Methylin
Metadate
Daytrona
Ampetamine/Dextroamphetamine (ages 3 and up):
Adderall
Dexedrine
Dexrostat
Lisdexamfetamin (ages 6 and up):
Vyvanse
Adverse side effects for stimulants:
decreased appetite
disturbed sleep
increased anxiety
irritability and aggression

When using stimulants, other factors should be taken into account, such as:
short acting forms have stronger peak effects and stronger rebounds
long acting forms can be better tolerated
when changes in stimulant medications need to take place, it is generally better to change to a different active agent
Murry, M., Penn State
Murry, M., Penn State
Autism Speaks
Alpha Agonists for ADHD Symptoms
Clonidine
Guanfacine
These can be used alone or with a stimulant

Effective for impulsivity and motor overactivity

Adverse effects:
orthostatic hypotension
mood irritability
fatigue
Murray, M., Penn State
Selective Serotonin Reuptake Inhibiters (SSRI).
Approved for youth for treatments of depression, anxiety, and OCD:
Lexapro (12 and up)
Prozac (8 and up)
Luvox (8 and up)
Zoloft (6 and up)
Murray, M., Penn State
Autism Speaks
Autism Speaks
Teachers should know that if a students is given an SSRI, it generally takes 4-6 weeks to measure its efficacy before considering if more dosage is needed. Telling the parents that the medication is not working, would not be appropriate.

Teachers should also note what the adverse reactions could be:
insomnia
GI distress
behavior disinhibition
Of a serious note of matter is that the FDA issued a "black box label" on all antidepressants for children and young adults (up to 25) warning that the patients be closely monitored for worsening symptoms of depression and suicidal thoughts.
Sleep with ASD children differs in delayed sleep, briefer REM periods and decreased stage 3 and 4 sleep. Medications helpful for sleep are:
Trazadone
Mirtazapine
Clonidine
Melatonin
Murray, M., Penn State
Murray, M., Penn State
There are three major classes of drugs in consideration for treatment of ASD.
They are selective serotonin reuptake inhibitors (NIMH, 2013) psychostimulants, typical antipsychotics, typical and atypical, (Blankenship, Erickson, Stigler et al., 2011) and although there are divers of medications that are being prescribed for ASD, they are being prescribed off-label. An off-label designation means that U.S. Food and Drug Administration (FDA) have not approved them in the treatment of autism. This does not necessarily mean that the drugs are not effective, it means that more research is needed to determine if the medications are safe and effective in treating children with ASD.

There are many interventions that can be used for ASD and symptoms of ASD. They will be further discussed this afternoon.
One of the interventions that will be discussed at now is the use of Augmentative and Alternative Communication (AAC). AAC's are not stand-alone intervention, while some of the interventions that will be further discussed are.
Regardless of the students' language ability AAC's can range from helpful to necessary. AAC's can range from high-tech to low-tech. The goal is to help students be able to communicate and express themselves through the use of the AAC.
Can all of my students use AAC's?
There are two types of AAC's, aided and unaided AAC's.
Unaided AAC's rely on the users body to convey messages. Aided AAC's require the use of tools, plus the person's body to communicate.
Social Deficits?
Lewis, M. et al
Some devices require the user to spell words and other devices use pictorial representatives for words, or the word spelled out. They can even be programmed to include words and names most often used by the student. Dynamic displays change between functions, but static displays remain the same.
Examples of low-tech Picture Exchange Systems for the classroom.
No-Tech ACC
Examples of no-tech AAC is using signs for communication. This can include sign language or even blinking with eyes.
Mid-tech AAC's generally have a static design (the same set of words programmed) and they generate speech according to which picture symbol is pushed.
High-tech options can be very expensive, but very versatile in use. Usually more training is necessary for use. They perform as a computer system and the voice output design is more sophisticated and can even have word prediction.
AAC's are intended to enhance existing functional communication by:
1) Clarifying vocalizations, gestures, body language, etc.
2) Expanding the language of limited speakers by increasing their vocabulary to include verbs, descriptors, exclamatory comments, etc.
3) Replacing speech for people who are nonverbal;
4) Providing the structures and tools to develop language.

Do you think that the use of AAC's hinder communication growth?

No, in fact, research shows that AAC's facilitate growth in language skills.
Califero, J., Meaningful Exchanges for People with Autism
Califero, J., Meaningful Exchanges for People with Autism
Califero, J., Meaningful Exchanges for People with Autism
Califero, J., Meaningful Exchanges for People with Autism
Interventions
Seeking effective interventions for ASD students takes a interdisciplinary approach in finding what is most effective for the student in being successful at school, and at home. As you can see, there are many options for our students. Each plan should be individualized and appropriate for each student.
The Fuel (Catalyst) for it all.
The foundations for all of the approaches discussed are based on the sucessfulness of the students by positive input and positive approaches.
Positive Behavior Supports
Positive behavior supports can help ASD students with problem behaviors. PBS can be implemented with all of the interventions that we have discussed.

Students with ASD and ED may have difficulty communicating dealing with their environment, as well as communicating their wants and needs. An important part of PBS is figuring out what the function of student's behavior is.
Association for PBS
PBS are effective for ASD students by providing the student direct and indirect instruction ways to replace problem behaviors. PBS can implement changes in the students day to help them be successful. This would include changing routines, situations, and settings so that the students can avoid the situations that trigger the problem behaviors.
APBS
You should know that PBS is not new. Like we talked about, it is based on the science of Applied Behavior Analysis. PBS in not one program or specific strategy. As teachers, it's important to remember that sometimes even the best plans will not work at all times. This is why it is important to have a variety of supports.
PBS:
prevent challenging behaviors
teach new skills
use team approach


One model of PBS is
Antecedent Based Interventions
Uses a variety of strategies:
preferred interests, activities, items to increase interest/motivation and manage behavior
embed in schedule
use in curriculum
reinforcement
change/alter the schedule/routine
visual schedule
adult vs. student directed
preferred vs. non-preferred
Transition interventions
warnings
timers
routines
Choices
Differentiated Instruction
Access to sensory stimuli
Another model is the Prevent Teach Reinforce model. This model uses looks at data and functions for behavior to best prevent behaviors. The model then determines what behaviors need to be taught or retaught to the student/s. And then what reinforcers will best prevent future maladaptive behavior or reinforce future positive behaviors.
Challenging Behaviors.org
All of the PBS models use an Functional Behavior Assessment. The FBA is a foundational component of the FBA. The FBA uses a antecedent, behavior, consequence model.

The team must determine what the function of behavior is by looking at the
Antecedent - where, when, who, demands/expectations, environmental arrangements, instruction/curriculum
Behavior - what happens during the occurance
Consequence - what happens after
All of the PBS models use an Functional Behavior Assessment. The FBA is a foundational component of the FBA. The FBA uses a antecedent, behavior, consequence model.

By looking at the FBA, the team can determine the function of the behavior.

Is it to get/avoid something
Is it a skill deficit
Is it performance deficit
ASD symptoms of rigidity/routines, lack of generalization/over generalization
Giving students Positive Behavior Supports focus both on prevention of problem behaviors and give early access to effective behavior support. Also, just as importantly, they are culturally competent and are family-friendly behavior supports.
Implementation of PBS of sufficient intensity and precision can produce behavioral gains that have a significant and durable impact on the academic, social and living options available to the student.

NASP Online
Today we have learned much about what is best for our ASD learners. Many aspects you are already implementing well. New components you have learned today will be implemented through your Special Education team, along with your LSSP. Please contact the team leader for more information.
Specific Changes from DSM IV to DSM V
Using DSM-IV, patients could be diagnosed with four separate disorders: autistic disorder, Asperger’s disorder, childhood disintegrative disorder, or the catch-all diagnosis of pervasive developmental dis- order not otherwise specified. Researchers found that these separate diagnoses were not consistently applied across different clinics and treatment centers.



Facts from CDC-

Boys were almost 5 times more likely to be identified with ASD than girls. About 1 in 42 boys and 1 in 189 girls were identified with ASD.
White children were more likely to be identified with ASD than black or Hispanic children. About 1 in 63 white children, 1 in 81 black children, and 1 in 93 Hispanic children were identified with ASD.
Almost half (46%) of children identified with ASD had average or above average intellectual ability (IQ > 85).
Less than half (44%) of children identified with ASD were evaluated for developmental concerns by the time they were 3 years old.
On average, children identified with ASD were not diagnosed until after age 4, even though children can be diagnosed as early as age 2.
About 80% of children identified with ASD either had a special education eligibility for autism at school or had an ASD diagnosis from a clinician. This means that about 20% of children identified with ASD had documented symptoms of ASD in their records, but had not yet been classified as having ASD by a community professional.
ABA
K - W - L
Why the review the Autism and Emotional Disturbance?
Understanding the what's and why's can help us to provide the best interventions for our students with behavioral difficulties.....
Has your student had any of the following difficulties?.....
3. Remember, they’re kids first. By and large, students with emotional disturbances aren’t scary, dangerous, or time bombs waiting to go off. They are themselves, in need of your skill and support, and quite capable of learning. Do not permit bullying, teasing, demeaning, or exclusion of the student by other students—or by the system.
Examples of Aversive
Stimulus?
Red light is stimulus for putting brakes on.

Growling stomach is stimulus for eating.
Eating is a behavior while
digesting food is not.
A consequence is an event that follows the behavior. A consequence will increase or decrease the probability of the behavior occurring again in the presence of the same antecedent. Reinforcing consequences increase the probability of the behavior occurring again, and punishing consequences decrease the probability.
Three Term Contingency - A>B>C
Antecedent, Behavior, Consequence.

After the bell rings for class to begin, Bobby is not in the classroom. Ms. Smith finds Bobby in the hall and tells him to come into the classroom. Bobby tells Mrs. Smith he has to go to the bathroom. Ms. Smith tells Bobby he should have used the restroom between bells instead of hanging out with his friends. Bobby starts yelling at Ms. Smith about how mean she is for not letting him use the restroom and that she wants him to wet his pants. Ms. Smith tells Bobby to use the restroom.


Antecedent =
Behavior =
Consequence =
Josh rarely completes his work. When he does finish it he rushed through the assignment and turns it in with a lot of mistakes. After he turns in his assignment he bothers the other students. One day after Josh turned in his work, Ms. Smith told Josh he could play his favorite computer game for 1 minute for each correct answer. Now Josh always finishes his work correctly.

A =
B =
C =

Procedure =
Reinforcer Effectiveness (DISC) -
Sue typically gets out of her seat and wanders around the room during seat work activities. One day she remains in her seat, on-task, during the morning activity. Ms. Smith praised Sue for staying in her seat during the morning activity as Sue got on the bus to go home.

Which principle was not followed?

When Michael bites himself the assigned task is removed and he plays with his favorite truck. One day Michael finishes his work without biting himself. Ms. Smith decides to try reinforcing him for completing his work so she gives him his favorite truck.

Which principle was not followed?
John's favorite edible is popcorn. His mom sent a bag of popcorn with his lunch. John ate 1/2 the bag and threw away they rest of the bag. After lunch, Ms. Smith decided she would give John popcorn if he finished his work. John didn't finish his work. Ms. Smith said, "reinforcement doesn't work with John."

Which principle wasn't followed?

Betty will work on mastered tasks for short periods of time with frequent praise. Ms. Smith only praised Betty when she is working. As long as Ms. Smith praises Betty she will continue to work on a simple task. Ms. Smith gives Betty a new task that is very difficult. Betty stops working on the new task even though Ms. Smith praised her when she was on-task. Ms. Smith says "reinforcement works on Betty for only easy tasks."

Which principle wasn't followed?
The procedure in which unpleasant stimuli are presented to a person after a behavior is called positive punishment. Positive punishment DECREASES behavior.

Examples????

Positive punishment is positive in the sense that something is added to the environment.
= Positive Punishment
= Negative Punishment
The procedure in which desired stimuli are withheld or removed from the person after a behavior is called response cost, or negative punishment. This DECREASES behavior. That is, people are less likely to repeat the behavior that is followed by a response cost.

Examples???

Negative punishment in the sense that something is subtracted or removed from the environment.
Extinction: Procedure in which a behavior that has previously been reinforced is no longer reinforced. Decreases FREQUENCY of behavior.

Examples???

When introduced, the target behavior often briefly increases in frequency before it decreases. (Extinction burst)

Planned Ignoring: Ignore minor misbehavior by taking away your attention. Remember that paying attention to misbehavior can accidentally reward the person and can encourage him to repeat the behavior.


Pro-action is about being prepared and in control. It's about knowing what is going to happen and when. Proactive classroom control begins with setting the tenor in your room in the first few minutes before behaviors can become problems.
In contrast, REACTION is about doing "this", because some kid did "that!" It's about dealing with problems as they come up. Soon you're finding that a second problem comes along while you're still dealing with the first.

Modifications to the
Classroom Environment:
*Assign student a seat that allows him to avoid distractions
*Eliminate noise, excessive visual stimuli and clutter
*Avoid "overloading" the student with too much verbiage
*Provide an individualized written schedule




Memory Assistance:
Have the student progress through the progress through the following steps while learning: See it, say it, write it, do it.

Testing Accommodations: (IEP)

Transitions:
Set up routines that prepare the student for upcoming transitions
Set expectations for behavior BEFORE and activity or event


Planning What to do in our Classrooms and How to do it.....

Consider 3rd grader Ken, who currently lives in a foster home. He struggles with reading, and when he gets frustrated, he'll either hide behind a bookshelf in Ms. Silva's classroom or charge for the door and then lurk in the hallway. He often growls when reprimanded and throws books off his desk, screaming things like, "You hate me and school sucks!" Ken pushes other students so he can be first in line, and he has trouble sharing; he'll grab all the materials when working on a project with other students. One time when the principal reprimanded him, Ken exploded and slapped the principal's glasses off.


What's the Function of the Behavior?

When working with students like Ken, it's important to avoid power struggles that may escalate the consequences and inadvertently reinforce the negative behavior. Behavior happens for a reason and is a form of communication; determining the intent or function of the behavior—enables us to better understand the behavior and decide how to intervene.
Behavior analyst Mark Durand1 outlines four possible functions of behavior: to escape, to obtain a tangible thing, to engage in sensory activities, and to get attention. These functions describe the benefit students get from the behavior—a benefit they may not even be aware of—and help us understand how to intervene to help students change the behavior.

We can understand tangible behavior in two ways: when the function of the behavior is to obtain a tangible object like money or food or, as in Ken's case, when the function is to attain a specific agenda. The student wants what he wants when he wants it. Students who are self-centered and have inflexible thinking often fall into this category. Some children with a history of abuse or neglect may have a low frustration tolerance and operate with the assumption that the only way to get their needs met is to grab the thing they want or overpower someone.
Escape-motivated behavior occurs when a student attempts to avoid a task, demand, situation, or person. This can be easy to recognize—for example, when Ken runs out of the classroom during reading. Sometimes it's less obvious—for instance, when kids argue to get out of doing an activity that makes them anxious. Common school procedures, such as time-outs or sending the student to the principal's office, can reinforce escape-motivated behavior because they remove the student from the undesirable activity—just what the student wanted.


Identify Procedure and Function

One day Lee yelled and screamed when his teacher gave him a worksheet. His yelling and screaming was so loud and disruptive his teacher sent him to timeout. Now every time his teacher gives him a worksheet he yells and screams until she sends him to timeout.

Procedure=
Function=
Behavior Management Strategies:
*Develop good rapport with the student
*Ignore as much of the negative behavior as possible
*If you get a lot of defiant or oppositional behavior, review how often you say negative things and give commands. If ASD and ED students hear too many negative and commands, they will shut off the person they come from.
*Give attention to appropriate behaviors
*Prompt the correct behavior immediately and verbally reinforce it frequently
*Allow students to move or use fidget item
*Proximity
*Assign duties that require self-control (e.g., line leader, materials distributor)
Procedure involves manipulating some aspect of the:
Physical environment
Social environment
The result of the procedure is to:
Make the target behavior more likely
Make competing behaviors less likely
Definition:
Antecedent stimuli are manipulated to evoke desirable behaviors. Once present these behaviors are differentially reinforced, which also decreases competing behaviors that interfere with the target behavior.
There are two kinds of antecedent control manipulations:
Those that evoke the target behavior
Those that make competing behaviors less likely

Antecedent Manipulation:
Examples of Antecedent Manipulation...?

What potential problems do you see with antecedent manipulation?
***
Magnets.........................*****
Positive and negative punishments
Keeping Student on Task:
*Reduce length of assignments so that students remains engaged and doesn't feel overwhelmed
*Present assignment in parts
Keep unstructured time to minimum
*Use "secret" dialogue or symbol to remind him to stay on task
*Use timers
*Give student choices...............!
K - W - L Chart

Put your "L"s on the chart.......
Autism
K - W - L

Put your "L"s
on the Chart.
They all take
Teamwork
Reaching All Students:
Vary your delivery
Modulate your voice
Use a voice level that can be heard easily in the back of the room
Be very animated in your delivery, using facial expressions and body language
Move around

Encourage All Students:
Accentuate the positive
Let students know that you expect them to succeed
Talk and interact with as many students as possible, not just your favorite students


Decreasing Behaviors-

Differential Reinforcement procedures: Behavior is less likely to occur again when followed by a positive consequence

Extinction procedures: Behavior is less likely to occur again when it receives no reinforcement

Reinforcement removal (response cost): Behavior is less likely to occur again when it is followed by removal of something positive

Aversive procedures: Behavior is less likely to occur again when it is followed by a negative consequence
Brain Images of Children with ASD
Possible characteristics we may see with students wit ASD in your classroom.

Cognitive Learning:
Excellent rote memory in certain areas
Ungregulated fears; difficulty judging situation that creat fear
Very detail-oriented
difficulty seeing overall picture or situation
May have exceptionally high skills in some areas, but very low skills in others
Prefers concrete rather abstract concepts

Difficulties understanding the facial expressions of others
Difficulties with or complete lack of initiating social interactions with others

Lack of responding to social initiations made by others
Lack of responding to the emotions of others
Deficits in showing
Lack of interest in other children

Absence of or limited use of gestures such as pointing to share enjoyment with others

Absence of or limited imitation skills

Lack of friendship seeking behavior


Research has also shown that the social interactions of individuals with autism are significantly different from those with other developmental disabilities like Down syndrome. Individuals with autism have been found to be less likely than those with other developmental disabilities to orient to social stimuli, to respond to the social bids of others, and to initiate social interactions with others (joint attention.)
Do you see social deficits with ASD
children in your classroom?
Children with social deficits may have:
Way before babies begin to speak, they communicate their needs, wants, and interests with others through a combination of vocalizations, facial expressions and various non-verbal gestures.
One of the earliest signs of social interest in others is the typical newborn’s preference for the human voice over other sounds.

While typically developing children are attentive to others and show social behaviors at a very early age, individuals with autism often exhibit difficulty engaging in social interactions throughout their lifetime.



One aspect of this is using joint attention. This occurs when infants are able to self-organize social information. In doing so, learning is promoted in structured and incidental learning opportunities. Joint attention is a necessary skill for cognitive skills such as social referencing, language acquisition and learning through modeling behaviors of others around you. Without the ability of joint attention, children would not be able to learn how to speak or get their parents attention when they want something. Joint attention is also important for later skills, like more complex expressive language and symbolic play.

Social interaction deficits are a core deficit of autism. Some suggest that the presence of deficits in reciprocal social behavior distinguishes autism from other psychiatric disorders.
Social Deficits???
One of the myths of autism is that children have an inability to show attachment, but studies say ASD children do, just in a different ways. One of the difficulties is the fact that children with ASD find it hard to read body language, facial expressions and voice inflection.


How is this a challenge in the classroom?



How can you help in the classroom with social deficits?
Build a relationship with your student. Yes!!!
Understand where his skill set is
Understand that unstructured times are most difficult so provide structured activities during recess, etc.
Model social interaction and point out good models in the classroom.
Have a peer with good social skills be his partner
Teach social skills classes to promote social boundaries, listening skills, anger management, context clues (if everyone is standing, you stand too.)
Teaching about empathy.
Emotional Disturbance

K-W-L

What do I know?
What do I want to know?

Remember what you learned......?
For school purposes, there is a difference between diagnosis and eligibility. The Individuals with Disabilities Education Act (IDEA) requires that public schools provide assessment, free of cost, to determine eligibility for services through the school. Assessment is made by an interdisciplinary team working together to determine eligibility in determining disability that affects communication and social interaction.
IDEA and Emotional Disturbance: Long ago school staff figured out that some students had the intellectual ability to do well in school, and yet did not. These students sometimes had difficulty building connections with others, demonstrated challenging behaviors, were fearful of things other students were not, and/or were clearly unhappy. Sometimes, in fact, it was nearly impossible to figure out what the problem was. Well, in some cases these students were suffering from what IDEA eventually defined as an emotional disturbance.
IEP paperwork it says Emotional Disability. According to the U.S. Department of Education, IDEA defines an Emotional Disturbance as:

"a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:

(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.
(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
(C) Inappropriate types of behavior or feelings under normal circumstances.
(D) A general pervasive mood of unhappiness or depression.
(E) A tendency to develop physical symptoms or fears associated with personal or school problems.

Usual Diagnoses Don't Necessarily Apply

Oftentimes DSM-V related diagnoses such as clinical depression, which might be tied to characteristic C of the emotional disturbance guidelines- a general pervasive mood of unhappiness or depression- accompany an educational emotional disturbance classification.

Same thing could be said for a DSM-V anxiety disorder of some sort impacting or being correlated with characteristic E- a tendency to develop physical symptoms or fears associated with personal or school problems. That said, the term Emotional Disturbance as it relates to IDEA is not the same thing as a DSM-V diagnosis often made by a psychiatrist or psychologist.
Usual Diagnoses Don't Necessarily Apply

Oftentimes DSM-IV related diagnoses such as clinical depression, which might be tied to characteristic C of the emotional disturbance guidelines- a general pervasive mood of unhappiness or depression- accompany an educational emotional disturbance classification. Same thing could be said for a DSM-IV anxiety disorder of some sort impacting or being correlated with characteristic E- a tendency to develop physical symptoms or fears associated with personal or school problems. That said, the term Emotional Disturbance as it relates to IDEA is not the same thing as a DSM-IV diagnosis often made by a psychiatrist or psychologist.
Usual Diagnoses Don't Necessarily Apply

Oftentimes DSM-IV related diagnoses such as clinical depression, which might be tied to characteristic C of the emotional disturbance guidelines- a general pervasive mood of unhappiness or depression- accompany an educational emotional disturbance classification. Same thing could be said for a DSM-IV anxiety disorder of some sort impacting or being correlated with characteristic E- a tendency to develop physical symptoms or fears associated with personal or school problems. That said, the term Emotional Disturbance as it relates to IDEA is not the same thing as a DSM-IV diagnosis often made by a psychiatrist or psychologist.
Speaking of qualifying, applying the criteria of the presenting behavioral/emotional issue being present for a long time, to a marked degree, and with an adverse effect on educational performance is key. Even if there is a psychiatric diagnosis, if the emotional problem does not have an adverse effect on educational performance then the student does not qualify for special education services.
Speaking of qualifying, applying the criteria of the presenting behavioral/emotional issue being present for a long time, to a marked degree, and with an adverse effect on educational performance is key. Even if there is a psychiatric diagnosis, if the emotional problem does not have an adverse effect on educational performance then the student does not qualify for special education services.
School teams have an obligation to make recommendations based on a student's least restrictive environment. Loosely, this translates to keeping them in programs that their non-disabled peers engage in to the greatest extent possible.
Working with a child with
behavioral needs in your classroom.
Emotional disturbances carry with them a stigma, despite being surprisingly common in both children and adults. Most of us know someone who’s depressed, lives with chronic anxiety, experiences inexplicable panic attacks, or compulsively washes his or her hands or must do things in a particular order. Some of us are those people.
Emotional disturbances carry with them a stigma, despite being surprisingly common in both children and adults. Most of us know someone who’s depressed, lives with chronic anxiety, experiences inexplicable panic attacks, or compulsively washes his or her hands or must do things in a particular order. Some of us are those people.
Teachers are often among the first to suspect that a student may have an undiagnosed emotional disturbance. (2) They may notice a student’s ongoing problems with interpersonal relationships, for example, or signs of unreasonable anger, an eating disorder, or self-injurious behavior. It’s also not uncommon for teachers to refer such students for evaluation, to see that they are connected with the systems of supports and services that can be genuinely helpful, even life-changing.
Emotional disturbances can affect many different aspects central to student learning, including (but not limited to): concentration, stamina, handling time pressures and multiple tasks, interacting with others, responding to feedback, responding to change, and remaining calm under stress. (4) Many of the medications prescribed to address the disturbance also have side effects that can impact student learning.
The "L"s for Emotional Disturbance
Teachers are often among the first to suspect that a student may have an undiagnosed emotional disturbance. (2) They may notice a student’s ongoing problems with interpersonal relationships, for example, or signs of unreasonable anger, an eating disorder, or self-injurious behavior. It’s also not uncommon for teachers to refer such students for evaluation, to see that they are connected with the systems of supports and services that can be genuinely helpful, even life-changing.
What does ABA look like???
Everyone wants to change or modify someone's behavior. Maybe you want your husband to pick up his socks off the floor, your child to start their homework as soon as they come home, or that friend to stop calling after 10 PM. Regardless, whether it's your son, daughter, husband, wife, or friend, the desire to change someone's behavior for the better is relevant to every environment, situation, and walk of life. The often utilized term for this in special education circles is behavior modification

5. The techniques are based largely on principles of learning – specifically operant conditioning and classical conditioning
6. There is a strong emphasis on scientific demonstration that a particular technique was responsible for a particular behavior change.
7. There is a strong emphasis on accountability for everyone involved in a behavior modification program.
1. Learn more about the student’s specific mental health disturbance. A mood disorder such as depression will affect a student’s demeanor, thinking, learning, and behavior differently than an eating disorder like anorexia or bulimia. Knowing how the particular emotional disturbance manifests itself and is managed can help you support the student’s education in individualized, informed, and effective ways. Consult the organizations we’ve listed in our Emotional Disturbance fact sheet for expert guidance about specific emotional disturbances.
2. Learn more about the student’s strengths, too. The student brings much more than an emotional disturbance to class. What about his or her strengths, skills, talents, and personal interests? All of these are tools in your hands as you adapt instruction, give out assignments, ask the student to demonstrate learning, and create opportunities for success.
Language:
Pronoun reversal
Conversation may sound stilted
Makes honest, but often inappropriate observations
Has difficulties adjusting volume and speed in speech
Literal language-difficulty understanding idioms, similies, parodies

Emotions:
Rage/anger/hurt may all be expressed as rage
Perfectionism
Easily overstimulated by sound, crowds, lights, smells
Inside feeling not matching outside behavior

Perseveration:
Obsession
Compulsions
Fascination with rotation
Many collections
Redirection very difficult
One emotional incident can determine the mood for the rest of the day
Social Cues:
Difficulty reading facial cues and emotions
Understanding body language
Understanding rules of conversation
Too much or too little eye contact
Understanding others' humor
Standoffish or over friendly

Comfort Skills:
Desires comfort items to produce calming effect
Comforted by minor motor stimulation-rocking, humming, tapping fingers
May need separate area to decompress

Senses:
May experience physical pain from oversensitivity
Over sensitive to change in surroundings, people, places

Neurological Function:
Attention difficulties
Irregular sleep
Sensory processing disorders
Visual processing disorders
Auditory processing disorders

New situations, Patterns, People:
Rule orientated
Prefers known pattens
Prefers familiar people, places, clothing
Difficulty with transitions
Difficulty with making an maintaining friendships
We see sensory behavior when a student is motivated by sensory input: Things feel good, look good, taste good, or sound good. Humming loudly while writing, chewing on the end of a pencil, or standing rather than sitting while working are all typical behaviors that fall into this category. These become problems when they interfere with learning, are disruptive, or make students look odd to their peers.
Finally, with attention-motivated behavior, the student tries to gain attention from an adult or peer. This can present as the student being belligerent, screaming, or continually interrupting the teacher. It can also work in the positive—that is, the girl who dresses up so a boy will notice her or a child who works hard on his reading so the teacher will praise him.
Negative Is Better Than Nothing
Teachers are sometimes surprised that negative attention, such as lecturing or redirecting a child, can reinforce attention-seeking behavior. For some kids—including those with social deficits who may have difficulty recognizing more subtle communication—even negative attention is better than no attention. Kids may prefer negative attention because it's dramatic; efficient (easier and faster); predictable; and more obvious than positive attention.
Consider Rebekka, a 6th grader with Asperger syndrome, who comes from a stable home. She's often loud and interrupts others. When she enters her science class, she'll often shout out inappropriate things, asking certain students whether they're gay or telling the teacher that "this is BS!" and that he clearly never went to college. When she gets upset, she yells.

If Rebekka enters the classroom quietly, she may not be able to predict when the teacher will give her attention. But if she swears, she knows that the teacher is going to attend to her behavior immediately. Rebekka may have learned at home that the best way she can engage adults' attention is to act inappropriately. A familiar example is fighting with a sibling when a parent is on the phone to get the parent's attention.
Taking notes in an ABC format2 can help teachers see patterns in students' behavior. A is for antecedent (what happens immediately before an incident); B is the description of the student's behavior; and C is for consequence (the staff member's or a peer's immediate response to the student's behavior).

Ken's teacher, Ms. Silva, takes ABC notes to observe what's happening in the environment right before Ken's incidents of aggressive behavior and to look at the consequences to help her recognize patterns. She sees from her notes (fig. 1, p. 21) that when she puts one glue stick on a table for three students (the antecedent), Ken hits other kids to get it first. When students line up for music class (the antecedent), Ken pushes a student so he can be first in line. The notes indicate what triggers him; they also highlight his skill deficits. In this instance, Ken has trouble waiting to be first and waiting to get an object. He probably also has difficulty with perspective-taking: He can't understand why someone else has to be first sometimes and why someone else may need the glue stick.
Ms. Silva can also see how effective her responses were. The notes show that Ken (1) successfully got the glue stick to himself, (2) was first in line and then was able to sit out during music, (3) was first in line going to lunch, (4) lost his library time, and (5) wasn't permitted to use dice during vocabulary bingo. In three of the five incidents, Ken achieved his agenda. Knowing this, Ms. Silva will think about responding in a way that's more likely to reduce Ken's aggressive behavior rather than reinforce it.
Which Accommodations Should We Use?

Once we know the function or intent of the student's behavior, it's easier to create a plan to change the behavior. In suggesting accommodations, we want to reduce the triggering aspects of the environment as well as explicitly teach replacement behaviors and underdeveloped skills.
For Ken, these accommodations might include
An assigned line order.
A "waiting bag" (activities, such as a Rubik's cube, to occupy him while he waits).
Lunch in the classroom with a couple of his peers instead of in the cafeteria. An adult should be present to remind Ken not to bully his peers or cheat at any games the students might play during this time.
A 20-5 schedule (20 minutes of schoolwork followed by a 5-minute break) to help him build tolerance to handle more work.
A safe, calming corner in the classroom Ken can go to, with Ken receiving points for using it.
A calming box (a box of objects that calm the student down, such as a weighted ball, a stuffed animal, an action figure, a portable music player with music, and so on).
The use of technology—such as spell check—to reduce Ken's aversion to writing.
Instruction in self-regulation strategies, such as labeling his emotions in the moment, and self-calming strategies, such as deep breathing or counting to 10.
An aide from another room to help Ken practice self-calming techniques once or twice a day in the calming corner.
Replacement Behaviors:
During the time it takes for students to improve underdeveloped skills—such as Ken learning to wait, take another's perspective, share objects, self-regulate, and think flexibly—it's important to teach them how to get their needs met more appropriately. By providing a replacement behavior that's not too difficult to handle, teachers help students behave more appropriately while gaining the skills they need so they no longer want to avoid the task at hand.
The replacement behavior needs to be as easy to implement as the inappropriate behavior, or it won't stick. Ms. Silva gives Ken a "break card" to keep on his desk. When he needs a break, he can hold it up and then go to the room's reading corner to sit in plush seats and take deep breaths. This replacement behavior is appropriate because there's no requirement to use language or wait for permission—Ken doesn't have the skills to do either when he's upset.
Teaching Self-Regulation
Teachers often recognize that students may have a low frustration tolerance and need help learning how to change their behavior when they're overwhelmed. But they may not be sure about the necessary skills to teach. Most students with challenging behavior lack the skill of self-regulation.

Just as they would do with all skill deficits, teachers need to explicitly teach this skill. This begins with teaching students to identify their own feelings. The teacher labels the student's emotion in the moment and then names specific behavioral attributes that can show the student what he or she is feeling (for example, "You're clenching your fists, your voice is loud, you're frustrated"). With practice, students can learn to assign themselves a self-calming strategy in these moments and avoid an explosive incident.
Which Interaction Strategies Work Best?

Many students who have challenging behavior have a history of school anxiety, school failure, and difficult relationships with authority. Teachers need concrete, easy-to-implement strategies to nurture students and convey to them that they are liked, respected, and safe. Building such a relationship can enable students to take risks and move out of their comfort zone.

Teachers are often skilled at positive reinforcement (for example, saying "Good job!" when a student acts appropriately), but they may not frequently use noncontingent reinforcement. We call this "random acts of kindness": ways to recognize students for who they are rather than for what they've done. When students get stuck in a negative cycle with a teacher, if the teacher takes time to show she cares—by bringing in their favorite snack, giving them a thumbs-up sign of recognition, or offering them a sticker "just because I like you"—these gestures can be crucial in helping students stop their challenging behavior. They learn that the teacher likes them for who they are, not just when they behave well.
How a teacher gives initial directions and talks with students has a huge impact on their behavior. One strategy is to give students some choice in a direction. Instead of saying, "Line up!" try, "Do you want to walk in the front or the back of the line?" You can also build a delay into the direction, giving students control over when they comply. Rather than saying, "You need to clean your desk right now!" which an oppositional student will resist, try, "You need to clean your desk before lunch."
Interaction strategies for Ken might include
Avoiding yes-or-no questions.
Using declarative language whenever possible (statements rather than questions or commands, such as "I see this is broken. We can fix it with some tape").
Embedding choice in instruction.
Using humor whenever possible.
Offering extended time for compliance with requests.
Offering positive and noncontingent reinforcement.
Building on the relationship by having lunch together once each month.
What Response Strategies Should We Use?

How a teacher responds to an agitated student can escalate, deescalate, or maintain his level of agitation. First of all, the teacher must avoid reinforcing the function of the behavior. If an attention-motivated student starts to argue and the teacher takes her into the hallway for a stern talk, the teacher has accidently reinforced the behavior. The student is likely to argue again the next day.

If Ken starts to argue, instead of responding verbally and perpetuating the argument, the teacher might write him a note that says, "please start reading quietly" and then quickly walk away, busying herself in another conversation or task (preferably with her back to him). This response will not only deescalate a situation that could have become loud and explosive, it will also reduce the likelihood that Ken will argue tomorrow because the teacher didn't reinforce his behavior with attention.
As a result of his plan, Ken learned to count to 10, take deep breaths, and appropriately ask for breaks when he became frustrated. Ms. Silva noticed it took him longer to get frustrated and that he was better able to tolerate not being first in line. After only three weeks of being on the plan, he stopped being aggressive with his peers. Moreover, his mother reported he was better at doing his homework at home.

Although teachers may feel at times that they cannot control challenging behavior, there are variables they can control. By understanding what the student is communicating, figuring out replacement behaviors, and building a strong relationship, teachers discover that seemingly intractable behavior can diminish and students can thrive.

Pointing the Way????

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How do define effectively use contingencies?
How can we FIND ***
ways to be proactive???
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