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Polk County PBS Academy

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Title: Polk County PBS Academy


1
Welcome!
2
Polk County PBS Academy
  • PBS 101

3
Training Objectives
  • To learn what PBS is as both philosophy and tools
  • Learn the basics of how we set the tone for the
    environment-to help or hinder
  • Learn basic tools of PBS
  • Learn how to use data to drive decisions

4
What is PBS
  • It is a philosophy and a set of tools
  • A way of thinking and doing
  • Positive behavior support offers a proactive
    process for
  • addressing behavioral challenges,
  • teaching adaptive skills, and
  • improving quality of life.

5
Polk County PBS Mission Values
  • We are an inter-agency coalition promoting
    positive support to enhance the quality of life
    for persons with disabilities.
  • We make decisions based on
  • Dignity respect
  • Long-term commitment
  • System consistency
  • Person-centered
  • Empowerment through training, support,
    education
  • Reducing the need for right restrictions
  • Promoting full citizenship and the exercise of
    choice

6
Insert Agency MVV Slide
  • Insert MVV Mission
  • Vision
  • Values

7
Insert Agency PBS Policy
8
Section One Philosophy
9
How you see me!
10
How I want to live!
11
Universal Enhancement Strategies
Gardening
Dancing
Religion
Hiking
Pets
Sex
Music
Spontaneity
Work
Fishing
Day at the spa
Grilling out
Good Health
Dining out
Family
Vacationing
Volunteering
Exercising
Movies
Voting
Having a will
Friends
Things of Value
Positive rituals
12
GEM
  • Good Enough for Me
  • Tom Pomerantz

13
I have come to the frightening
conclusion that I am the decisive element in my
environment. It is my personal approach, which
creates the climate. My daily mood makes the
weather. I possess tremendous power to make a
persons life miserable or joyous. I can be a
tool of torture or an instrument of inspiration.
I can humiliate or humor, hurt or heal. In all
situations, it is MY response that decides
whether a crisis will be escalated or
de-escalated and a person humanized or
dehumanized. ( Adapted- Halm Ginott)
14
Life
We must provide an environment that is healthy
enough for a life to happen.
Dan Berkowitz
15
Effective Behavioral Support
..requires the design of an environment that
makes problem behaviors

Irrelevant
Ineffective
Inefficient
16
Prove It!
  • Prove that
  • treating people with
  • dignity and respect
  • meeting unmet needs
  • bonding
  • decreases the frequency
  • and intensity of
  • challenging behavior.
  • Does it Matter?!

17
Respect Fundamental to PBS
  • A personal quality that is non-contingent
    provided without judgment and given equally to
    all persons.
  • People should not have to earn your respect they
    should be the recipient of your respect without
    condition.

18
Defining Characteristics of PBS
  • Person centered
  • Collaborative on-going process
  • Data-driven decision making
  • Prevention, positive, proactive strategies
  • Meaningful outcomes

19
  • IS NOT
  • Simple
  • Short term
  • Just Decrease Behavior
  • Reactive
  • Aversive (punish)
  • Observable Behavior
  • Experts Decide
  • IS
  • Comprehensive
  • Long term
  • Teach Useful Skills
  • Proactive
  • Positive (reinforce)
  • Function
  • Involve Individual

20
  • If an individual doesnt know how to read, we
    teach.
  • If an individual doesnt know how to swim, we
    teach.
  • If an individual doesnt know how to multiply, we
    teach.
  • If an individual doesnt know how to drive, we
    teach.
  • If an individual doesnt know how to behave,
  • weteach?.................punish?
  • Why cant we finish the last sentence as
    automatically as we do the others?
  • Tom Herner (NASDE President, Counterpoint 1998,
    p.2)

21
Section 2 ToolsHow we get to a Life!
22
Four Steps to Designing an Effective Behavior
Support Plan
  • Step One
  • Step Two
  • Step Three
  • Step Four
  • Gather Information
  • Develop a Hypothesis
  • Build a Support Plan
  • Evaluate effectiveness and modify support plan as
    needed

23
Step 1 Gather Information
  • Person Centered Planning

24
Five Essential Goals of Person Centered Planning
  • Expressing preferences and making choices in
    everyday life
  • Gaining and maintaining satisfying relationships
  • Having opportunities to fulfill respected roles
    and live in dignity
  • Being present and participating in community life
  • Continuing to grow

25
Characteristics of Person-Centered Planning
  • Includes focuses on the individual
  • Respects the individual and their dreams and
    choices
  • Emphasizes strengths, abilities, and capacities
  • Strength based Training principles
  • Individualized supports
  • Empowers the consumer and team

26
Tools for Person-centeredPlanning
  • Insert organization planning tools

27
What is behavior?
  • Anything a person says or does
  • 90 of behavior is communication
  • Must be observable and measurable
  • Must meet the dead mans test
  • If a dead man can do it, its NOT behavior

28
Behavior is method of communication both
verbally physically of hopes, dreams, fears,
anxieties, preferences, intentions and
prioritiesBehavior is also a method to cope
with or respond to demands from others control
and impulses, conform to generally accepted
social conduct, and or influences of the
environmentBehavior is the result of complex
neurological and sensory process.
29
He Had A Behavior
Of course he had a behavior! If he didnt hed
be DEAD!
There is walking behavior
talking behavior sitting behavior standing
behavior smiling behavior eating behavior
Have you ever been outside when there wasnt any
weather?
30
Behavioral Definition
  • Definition of behavior needs to be clear,
    concise, and specific
  • A description of what you will see when the
    behavior occurs.
  • Written so that everyone can agree when the
    behavior occurs.
  • When you talk about behavior, use these rules..

31
Specific Target Behaviors
  • Examples
  • high-pitched scream
  • Kicks chair over
  • Hits others/self
  • Completes tasks
  • Non-Examples
  • Poor impulse control
  • Angry, frustrated
  • Aggressive
  • Pay attention

32
Lack of Understanding
To call someone lazy, uncooperative or stubborn
is to admit we dont understand them.
Shes just plain stubborn. She refused to take
her meds again!
33
Step 1 Gather Information
  • Functional Assessment

34
What is Functional Assessment
  • A functional assessment is a process for
    identifying clear, predictive relationships
    between events in a persons environment and
    occurrences of a challenging behavior.
  • Not a data collection form
  • Not an event

35
Why Conduct a Functional Assessment?
  • provides clear information
  • allows strategies to be based on the function(s)
    of challenging behavior
  • leads to more durable outcomes
  • reduces the need for reactive interventions and
    crisis plans
  • addresses the needs of an individual
  • increases quality of life

36
Find answers to the BIG Questions
  • Under what conditions do the challenging
    behaviors occur?
  • What are the outcomes?
  • Under what conditions do the challenging
    behaviors not occur

37
A Functional Assessment Identifies Goals of
Intervention
  • Defines specific target behaviors to increase and
    decrease
  • Pinpoints circumstances in which intervention
    will occur
  • Identifies desired lifestyle changes, such as
  • Participation in integrated activities
  • Enhanced independence and satisfaction
  • Expanded social networks
  • Work!!! ?

38
What are the basics?
  • Gather information about the challenging behavior
    through direct observation, interviews, record
    reviews and/or rating scales
  • Develop a hypothesis after analyzing the
    information regarding the variables that starts
    and maintains behavior

39
The ABCs of a Functional Behavioral Assessment
  • Setting Event
  • the state a person is in, e.g., the person is
    tired, or hungry a state that predisposes a
    person to behave in a certain way given a
    particular antecedent.
  • Antecedents
  • any stimulus which precedes a behavior
    occurrence
  • Behaviors
  • any observable act of an individual the
    activity one performs in the presence of a
    particular stimulus
  • Consequences
  • the events which occurred following behavior

40
What are Consequences?
  • Consequences are events that follow a behavior.

41
Results or Functions of Behavior
Get
Sensory
Attention
Tangible
Get Away
Sensory
Attention
Tangible
42
Results or Functions of Behavior
  • Sensory
  • Escape
  • Attention
  • Tangible
  • Meet an unmet need

43
Why do people display challenging behaviors?
  • Biological/Medical Reasons
  • Drugs/medicine
  • Seizure activity
  • Allergies/hormonal changes
  • To mask pain or discomfort
  • Self-Regulation
  • To maintain a level of arousal
  • Reaction to a change in sensory input

44
  • Reinforcement
  • Internal-it feels good
  • External-to serve a purpose in ones environment
  • Absence of Alternative Skill
  • Most behaviors have the goal to communicate
  • Messages are sent through behavior
  • Control is the key word

45
Alternative Behaviors
  • What is the best way to decrease a behavior that
    is a barrier to getting a life?
  • Find an alternative behavior that serves the same
    function or purpose gets the same results.

46
Agency Examples of ABC
  • Practice identifying ABCs specific to
    organization.

47
  • Strengths-based slide?
  • Baskets A B C
  • Value of Life-Pomeranz

48
Competing Behavior Pathway
Desired Behavior
Consequence
Setting Event
Antecedent
Problem Behavior
Consequence
Alternative Behavior
49
Desired Behavior
Typical Consequences
Interact nicely do whats asked
Staff R Asked to do something
Problem Behavior
Setting Events
Triggering Antecedents
Maintaining Consequences
Scream, Hit head
Approach by Staff
Staff move away avoid request
Tired
Acceptable Replacement Behavior
50
  • Take what you can get closest to what you want!
    Reinforce even small improvement or steps to
    reaching the objective

51
  • Step 2 Develop a Hypothesis

52
What is a hypothesis
  • Your best guess about the function of
    challenging behavior

53
Hypothesis Formula
  • When this occurs (what is the setting
    event/antecedent).
  • The individual does (behavior)
  • To access or avoid (consequences or functions)

54
A Sample Hypothesis
  • When Sean..
  • (setting event) did not get to sleep before 11
    p.m. the previous evening or does not feel well,
  • (antecedent) is not engaged with others or when
    hes engaged in activities for 15 minutes or
    longer
  • (behavior) he screams, slaps his face and pulls
    his hair
  • (Consequences/function) to gain access to staff
    attention

55
Linking Hypothesis Statement to Behavior
Interventions
  • A hypothesis statement links behavior
    interventions to
  • short-term prevention of problematic situations
  • Teaching alternative skills
  • Responses to challenging behaviors, including
    crisis management
  • Long-term prevention
  • Lifestyle changes

56
In any situation there are three things involved
  • 1 The Environment
  • 2 The person
  • 3 YOU
  • It cannot be guaranteed that you will be able to
    control the environment or the person served
    however, you can control your own behavior.

57
What is a Behavior Support Plan
  • A written document that summarizes strategies
    that assist in preventing challenging behavior
    from occurring and helps the consumer learn new
    skills
  • The plan should
  • develop and maintain skills
  • enhance opportunities for learning and
    self-fulfillment
  • Focus on positive rather than negative techniques

58
A support plan is not written in stone. It was
made to be changed as a person grows and changes.
59
Is the plan working?
  • Are there improvements in challenging behavior?
  • Are there increases in skill development?
  • Are there improvements in quality of life?
  • Increased participation
  • Increases choice/decision making
  • Inclusion
  • Are there improvements in satisfaction?
  • Consumer and family
  • Staff and others
  • Are there improvements in health or well-being?

60
How do we collect this information?
  • Direct observation data
  • Incident reports
  • Interviews
  • Consumer
  • Parents
  • Service providers
  • Others
  • Informal anecdotal reports
  • Communication logs
  • Progress notes

61
Remember, PBS is all about
  • Determining the function of challenging behavior
    and then
  • Changing environments
  • Teaching new skills
  • Addressing quality of life issues
  • Changing our patterns of interaction

62
Review Training Objectives
  • To learn what PBS is as both philosophy and tools
  • Learn the basics of how we set the tone for the
    environment-to help or hinder
  • Learn basic tools of PBS
  • Learn how to use data to drive decisions

63
Point of View
  • When you change the way in which you see
    things-the things you see will change.
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