Module 2

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Module 2
Collaborative Teaming and Longitudinal Planning
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Values and Assumptions Positive Behavior
Support

• Responds to the persons unique characteristics
• Appropriate in a complex, changing environment
• Addresses needs of people who support the person
  with problem behavior
• Integrates education and intervention
• Focuses on lifestyles, not isolated practices
• Utilizes natural supports

OH 2.1
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Collaboration involves working together to
achieve a common goal.
Kagan, 1991 Rainforth, York, MacDonald, 1992
The American Heritage Dictionary, 1983.
OH 2.2
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Collaboration in Community-Based Behavior Support
for Individuals with Severe DisabilitiesPotential
Advantages

• Enhances information
• Encourages integrated and holistic approach
• Matches plan elements to resources
• Promotes a shared vision and commitment
• Builds competencies (cross-fertilization)
• Provides potential for systems change
• Offers support for support providers

OH 2.3
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Behavior Support Team.
A group of individuals who assess and develop
individualized, proactive, continuing supports

• Information Gathering
• Hypothesis Development
• Creation of the Support Plan
• Implementation of Intervention

OH 2.4
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Membership on Behavior Support Teams
Who Needs to be Involved?

• Members from all environments in which the focus
  individual interacts
• People who know the focus individual well and
  have a vested interest
• People who know supports and resources, (and
  methods of accessing them) as well as potential
  barriers
• Members to allocate personnel and fiscal resources

OH 2.5
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Characteristics of Members Who Facilitate Teamwork
CONTRIBUTORS Task-focused, dependable with
regard to activity completion COLLABORATORS Go
al-directed, support ongoing team
functioning COMMUNICATORS Process-oriented,
solve problems and encourage
interaction CHALLENGERS Questions goals,
methods, and systems Parker, 1990
OH 2.6
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Principles of Collaboration

• Mutual trust and respect
• Shared goals and objectives
• Open communication
• Effective conflict resolution
• Transdisciplinary process
• Equity of task distribution
• Consensus decision-making
• Ongoing problem-solving

Oh 2.7
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Service Delivery Options for Individualized
Family Support(Dunlap Fox, 1996)

• Information
• Education and training
• Planning and assistance
• Service coordination (case management)
• Social and emotional support
• Respite care

OH 2.8
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Supporting Families

• Focus on family strengths and accept their
  differences
• Respect the needs and aspirations of the family
• Build on existing resources and strengthen family
  
• Emphasize informal support systems (e.g.,
  extended family)
• Encourage family independence and self-reliance
• Develop the familys skill and competencies

OH 2.9
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Family Systems Model
Family Resources Characteristics of the Child
and Family Family Interaction Relationships
Among Family Members Family Functions Categori
es of Family Needs and Purposes Family Life
Cycle Developmental and Non-developmental
Changes within the Family
OH 2.10
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Food for Thought

• How do your previous experiences, capacities, and
  preferences influence your vision for the future?
• How does your vision for the future affect what
  you choose to learn to do?
• How do the perceptions of others influence how
  you perceive yourself and the future?
• What conditions need to be present in your life
  for you to take on a novel challenge, learn new
  skills, or make major change in your behavior?

OH 2.11
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Person-Centered Planning Philosophy

• Capacity-based perspective of the individual
• Use of natural resources to fulfill a vision
• Building a circle of support including friends
  family, and service providers

OH 2.12
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What is Person-Centered Planning?

• Planning Process
• Assessment Tool
• Intervention
• Motivational Activity
• Team Building Process

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Why is Person-Centered Planning so important to
PBS?

• Retains focus on the person
• Supports a team approach
• Broadens the level of analysis
• Changes participants
• Makes the functional assessment better
• Broadens the number of effective interventions
• Creates the best contextual fit

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Person-Centered Planning Process

• Personal Profile
• History of the individual
• Accomplishments
• Preferences and desires

• Strategy Planning
• Vision for the future
• Opportunities obstacles
• Strategies for achieving the vision
• Preliminary action steps

OH 2.13
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Five Essential Goals ofPerson-Centered Planning

• Being present and participating in community life
• Gaining and maintaining satisfying
  relationships
• Expressing preferences and making choices in
  everyday life

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Five Essential Goals ofPerson-Centered Planning
(cont.)

• Having opportunities to fulfill respected
  roles and live in dignity
• Continuing to develop personal competencies

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Characteristics ofPerson-Centered Planning

• Includes and focuses on the child and family
• Respects child, family, and team members
• Gives priority to expressed choices and
  preferences of the child and family
• Emphasizes strengths, abilities, and capacities
• Results in creative solutions

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Characteristics ofPerson-Centered Planning
(cont.)

• Accesses typical community resources
• Creates an environment where everyone is a
  learner
• Individualizes support
• Seeks ideals
• Empowers the child, family, and team

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Planning Alternative Tomorrows with Hope

• Tool to address long and short range planning
  Provides a timeline for achieving goals
• Utilizes group graphic techniques and involves a
  team of individuals committed to the focus person
• Takes 2-3 hours to complete

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Dustin
PATH
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Now
Increased attention to group instruction in
classroom.
Likes cereal and fruit juice and nothing else
Resourceful
Loves music, calms
Saying some words to get needs met
Good imitation skills
Holding BM and urine Not sleeping through the
night
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Enroll
Julie (Mom) Greg (Step Father) Bill (Dad) Linda
(Teacher) Carolyn (Aide) Nancy (SLP) Diannah
(ATC) Dr. Johnson Tammy (case-manager)
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First Steps
Julie Diannah call feeding clinic Linda- talk
to kindergarten teacher Linda, Nancy Diannah-
develop data sheets
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3 Months
Discussed feeding eval and developed plan Set up
situations to use greetings Modeling sentences
Increased time with typical kindergartners.
Following a toileting schedule On a regular
schedule picture schedule at home/school Bed
time routine established Support plan in place .
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1 Month
Feeding evaluation completed Collected baseline
data communication, social interactions,
toileting habits, sleeping habits Functional
assessment started Develop schedule and pictures
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Positive 1999-2000 Possible
Eating a variety of foods Communication Using
sentences Increase social verbalizations (e.g,
greetings) Increase interactions with
peers Voiding in toilet regularly Sleeping
through the night Decrease in tantrums
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The Dream ! !
Time Outdoors
Social Life
Life in the woods water
Social interactions, friends
Talking a lot
Living Independently
Safe
Someone available to help out
Normal
Job using Mechanical skills
Independent
Regular Classes
Cars, truck, trains
Baseball
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Making Action Plans(MAP)
Progressing at grade level
Develop behavior support plans

• Provides a road map for working toward
• and achieving goals
• Where the person currently is
• What the goal is
• How you will reach the goal
• Team should have a general idea of what the goals
  are before beginning

Fully included
Improved social skills
Better GRADES
More friends
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Making Action Plans(MAP)
What is the story? History?
What is the Dream?
What are the nightmares?
What is a MAP?
What is Plan of Action?
Who is this person?
What does this person need?
Strengths, gifts, talents?
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Who is here?

• L. Thomas - Mother
• M. Kenny - Classroom teacher (1 yr.)
• G. Ringer - Gym teacher (1 yr.)
• M. Hockman - Behavior Support / Relative (4
  1/2 yrs.)
• C. Beeman - Art teacher (1 yr.)
• C. Beard - Positive Behavior / Special
  Ed. (2 mos.)
• C. Kolb - 3rd grade / Positive
  Behavior (2 mos)

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What is a map?

• Set goals.
• Where are we?
• Where are we going?

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What is the STORY?

• Born 11/23/94 in Oakland, MD
• Cats and Dog
• No contact with biological Dad
• Switched formula (after 5 months), bronchitis,
  ear infections
• Busted head (2 years)
• 3 years old - home-based Head Start - C.
  Goerhinger
• Was close to Grandma (Nanny), aunt, Grandpap
• 1998 - 1999 Pre-K with M. Kenny and A. McKenzie
• Live in Cove (4 years)
• Carl - friend for 6 months
• Lindas brother for 6 months (Uncle to Keaton)

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What is the DREAM?

• Successful
• Father - Role model
• Success in school
• Positive school experience
• C. Beeman - More control behavior for successful
  school.
• Keaton - Power ranger
• M. Kenny - Better behavior

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What is the NIGHTMARE?

• Car accident
• C. Beeman - unhappy, frustration with school
• Small problems get larger
• Other kids wont interact with him
• House will burn up and Keaton wont get out
• Bully, no friends
• Not motivated

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Do Work

• Take away toys or tv
• Sometimes time-outs
• Missed activity
• Play dough and variety of activities

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Do NOT Work

• Threatening
• Timer
• Paddling
• Time-out
• Charts/stickers
• Apologizing
• Teacher-helper jobs
• Alternate structure

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Who is Keaton

• Energetic
• Curious
• Enjoys stories
• Lovable (hugs and kisses)
• Unmotivated
• Likes hands-on activities (keeps hands busy)
• At home he follows others and likes to be close
  to someone.
• Unaware of others and surroundings at school.
• Frustrated/Angry when given directions and asked
  to follow Pre-K rules.
• Self-destructive
• Difficulty communicating

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What is Keaton good at?

• Working with hands (play-doh)
• Good listener during storytime
• Knows all his colors and shapes and can draw well
• Recognizes most numbers from 1 - 10
• Loves to read books
• Cleans up at home (makes bed, cleans room,
  dresses self, trash, setting table)
• Anything that interests him - he will re-do
• Takes care of animals

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What are Keatons NEEDS

• Consistency
• Learning to handle frustration
• Consistent male role model
• Social interaction with children

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Plan of Action

• Practice gross motor skills (jump, hop, skip)
• O.T.
• School Guidance - awareness of personal space,
  social skills
• K - packet to assist with preparation
• Praise Positive attention
• Rewards Play - doh, trucks, tricycle
• Story hour over summer
• Male volunteer to do activities with Keaton
• Possible daycare over summer
• Possible church activities with other children
• Give a time frame to help focus

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Personal Profile and Futures Planning

• Personal Profile
• A team works to develop an understanding of a
  focus person
• Series of frames about the focus person
• Who is here? Choices
• People Respect
• Places Strategies
• History Hopes Fears
• Health Barriers Opportunities Themes

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History
Julies Mom gets ill during pregnancy
Blood pressure problems during pregnancy otherwis
e normal
Spring 94 Julie is pregnant
3/96 Julie goes back to work Dustin goes to day
care (change centers frequently)
Dustin develops normally but has ear infections
after he turns 1 yr.
1/94 Dustin born 8 lbs. 14 oz.
3/96 to 1/98 Day care workers began pointing out
differences between Dustin and other children
3/96 Julie and her family also are concerned
about Dustins lack of speech. Also limited
interaction with other kids, and did not want to
be held.
6/96 Dustin is in hospital due to seizures
Julie and Bill began having martial problems.
8/96 Julies Mom passes away.
8/96 Julie and Bill separate.
8/96-5/97 Dustin had some behavior difficulties
5/98 Greg and Julie Married moved into new house
6/ 98 Dustin diagnosed with autistic
characteristics
6/98 Dustin is in SLP and going
to Pre-school improvement is starting
Julie applied for Waiver SSI
Dustin continues to improve.
Approved for PBS with ATC
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Make food items (daily) Play Carmen
SanDiego House chores (daily) Reading Watch
T.V./movies (with trains or cars in them) Dustin
follow mom or yells for mom to make sure shes
still here Play on computer
PLACES
Pre-School- 3xs week 1/2 days Dustin rides bus
Home
School
Work
Community
Julie works in Morgantown Dustin goes to work
with Julie in the afternoon
Eat out (frequently) McDonalds, Burger King,
other fast food places Go to doctors
appointments
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2-18-99
Hutchinsons Family Schedule
Weekday
Weekend
800-820 Wakes, bathroom, dresses, watches TV,
820-830 Catches bus 830-1100 Dustin at
Pre-school 1105-1215 Dustin off bus-eats
lunch, watches T.V. 1215-100 Goes to
work. car rides to work is stressful 100-430 J
ulie working-Dustin watches T.V., Plays with
toys 430-515 Travel home 515-600 Pick up
some thing to eat or eat out. 600-900 T.V., 9
00-1000 Bath, brush teeth, read
book 1000-800 Dustin asleep-Julie has quiet
time. May wake during the night and stay up
the rest of the night Friday after school Dustin
goes to his dads
Friday afternoon through Monday Dustin is at
dads (Dustin spends time between grandmothers
and grandfathers on the weekends)
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(No Transcript)
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Choices
Family
Dustin
What Dustin wears Whether he goes to
school Medical care Where family lives
What he eats What he wants to play with What he
wants to watch Where he goes to school Where
Julie works and how much she works Julies
schedule Time Julie has to be at home to get
Dustin off the bus Where we go cant go to
mall or other places for shopping How the house
is decorated If everyone sleeps all night
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Adaptive Challenging Behaviors
Can tell basic wants and needs Help make
simple foods-like sandwiches Can dress himself,
but needs assistance sometimes Mostly toilet
trained Recognizes name Has some counting
skills, but unclear how far he can count Knows
alphabet Can bathe with assistance Turns off
lights, T.V. Opens doors when doorbell
rings. Seems to be mechanically inclined
Communication is still limited and is
echolalic at times. Does not communicate
emotions Screams Wont stay in car seat or seat
belt Kicks Throws Hits Holding Urine and
BMs Selective eating Will let anyone in the
house Will go with anyone Washing hair causes
tantrums Takes off clothes immediately if he
spills on them Low tolerance when asked to do
something Gets mad if other children touch him
while playing Resistant to parents touch (hugs,
being held) Getting up in the night Takes things
apart but doesnt put them back together
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Family Fears and Concerns
That Dustin will be made fun of once he enters
school (Julie) That he wont have friends
(Julie Greg) Will he ever play and communicate
like other kids? (Julie) What will happen when
we are gone? (Julie Greg) Dont have much say
when Bill has him (Julie) That he wont be able
to play sports (Greg) What if we dont get
waiver? How will we get assistance? (Julie)
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Family Stressors
I feel stressed when...
Driving to work Im trying to find someone to
watch Dustin I have to take care of Dustin and
house by myself dealing with Dustins eating
habits I have to take Dustin to work I have to
take care of the things Dustin needs I go to
meetings with the school Dustin gets up in the
night
Julie Julie Greg Julie Julie Julie Julie Juli
e Greg Julie Greg
4 2 2 3 4 4 2 4 3 4 4
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Stress Related Strategies
Work
Dont Work
Cleaning Take a nap Taking care of the
problem Talk to sister or friend Smoking (short
term)
Get mad-yelling try to forget about
it. Spanking Time out Smoking (long
term) Nagging Greg Fighting with Bill
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Themes
Julie is the primary person that takes care of
all of Dustins needs Taking Dustin to work is
difficult for Dustin and Julie Dustin is a very
capable little boy Dustin would benefit from
interacting with peers more Dustin sleep habits
are a major issue for everyone Julie and Bill
dont communicate much about Dustin Everyone
wants what is best for Dustin
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Personal Profile and Futures Planning

• Based on five goals of person-centered planning
• Focus on what team can do positive process
• Identify time frame for plan
• Areas to include
• Home
• Work or school
• Community
• Choices and Competencies
• Relationships

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Futures Plan
Home
Work
Improve tolerance to washing hair Improve
toileting and sleeping Increase Dustins
communications Teaching Dustin who can come into
the house and who cant Increase number of foods
Dustin will eat Communicate more with Bill Have
time to cook
Not having to take Dustin to work Increase work
hours Greg to work flexible schedule
Have more time for friends
Find activities for Dustin to do with peers
Community
School
Be able to go to the movies. Dustin join cub
scouts and t-ball Go to mall or shopping Julie
to take aerobics class Greg to start working out
again after work
Have someone else to meet bus Julie take a
class Dustin attend some regular ed classes with
peers Be aware of after school activities
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Circle of Support
1
2
3
4
First Circle Intimacy Third Circle
Participation Second Circle Friendship Fourth
Circle Exchange
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Dentist Dr. Smith
Speech Therapy Paula Jones
Pre-School Miss Sarah and Miss Kate
ATC Diannah G.
Doctors Dr. Johnson Dr. Bodensteiner Dr. Jellan
Barbara
Margaret
Gary (stepfather)
Grandma Grandpa
Dustin
Bill (Dad)
Julie (Mom)
Paul
Aunt and Uncles
Paula and Jon
Ronald
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Person-Centered PlanningA Summary

• PATH
• Takes about 3 hours
• Should have some idea of goals
• Team is cohesive knows focus person
• MAP
• Takes about 1-2 hours
• Well-formed goals
• Cohesive team knows focus person

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Person-Centered PlanningA Summary

• Personal Profile and Futures Plan
• Takes more time
• When team does not know focus
• person well
• Comprehensive
• Circle of Support
• Information about who is important in a persons
  life

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Positive Behavior Support Decision Matrix
Person Centered Planning
MAPS
PATHS
PPFP
OTHER
Functional Assessment
Indirect Methods
Direct Observations
Manipulations
ABC Data
Structured FA
Screening Tools
Brief FA
Interviews
FA Observation Form
Analog FA
Scatterplots
Checklists
Rating Scales
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PBS Hypothesis Development
Medical/ Health
Functional Assessment
PCP
Curriculum
Hypothesis Global and Specific
Multicomponent Interventions
Data Analysis and Evaluation
Generalization/ Maintenance
Effective
Ineffective
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Behavior Support Plan
Functional Assessment
Behavior Support Plan
Fundamental Principles of Behavior
Good Contextual Fit