Behavior intervention - Research Paper Example

who face behavioral difficulties with change or routine in a room setting The potential for picture activity schedules Behavior Intervention Project Report Name April 2014 Abstract A four-year old student diagnosed with a developmental delay condition and speech impairment was subjected to a behavioral intervention within a ‘least restrictive’ classroom environment. The aim was to help the student stay on her tasks by reducing the frequency off-task behavior. An A-B design was employed that involved scheduling a picture activity and reinforcing on-task behavior. By using time sampling, the student was observed for periods of 20 minutes each and assessed for each one minute time interval as to whether she was on or off-task. The results showed evidence of a significant reduction between the baseline and intervention phases with a reduction in the mean off-task time from 49% to 20%, a 59% decrease. The minimum and maximum frequencies in off-task behaviors were also reduced by 89% and 59% respectively with the minimum now only 5%. The effectiveness of the intervention strategy was established, and recommendations were made. Table of Contents Abstract 1 Abbreviations 2 A. Background 3 Profile 3 Difficulties 3 Classroom environment 3 Reason for targeted intervention 3 B. Target/Replacement behavior 4 C. Baseline Data 4 Data collection 4 Results 4 D. Functional Assessment 4 Data collection 4 Purpose 4 Observation 4 E. Hypothesis 5 F. Intervention 5 Intervention design 5 Rationale 6 G. Results 6 Method 6 Functional behavior analysis 7 Data analysis 7 H. Reflection 9 Effectiveness of the intervention 9 Overall impressions 9 Future possibilities 10 References 10 Abbreviations ARD Admission, Review and Dismissal DRI Differential Reinforcement of Incompatible behavior Procedure FBA Functional behavior Assessment IDEA Individuals with Disabilities Act IEP Individual Education Plan NEC Non-Categorical Early Childhood (Student) PPCD Preschool Program for Children with Disabilities A. Background Profile Name of patient: Lorelei Gender: Female Age: 4 years Grade: PPCD (Preschool Program for Children with Disabilities) Placement: A public preschool in Plainview, Texas Difficulties Lorelei was diagnosed with a developmental delay condition and speech impairment that makes her non-verbal. She is described as a Non-Categorical Early Childhood (NEC) student, and an IEP (Individual Education Plan) has been specially devised for her that specifically addresses language difficulties, as well as sensory and academic areas. She is also: Severally autistic; Independent in that she is able to do or get what she wants and whenever she wants; Unaware of boundaries; Inclined to prefer playing alone, and will leave if other peers join. An outside observer would be able to quickly see that Lorelei has difficulties with her body control and with her ability to integrate sensorily into the classroom. She is non-compliant and engages in self-injurious behavior. She often bangs her head for gaining attention, but she is unaware that banging her head too hard will hurt her. Classroom environment This is Loreleis second year where she is taught in a special PPCD along with 11 other special education students and ten other daycare students as peers who do not have a disability classroom. The teacher is assisted by three teacher assistants, and together they have the role of supporting all of the diverse learners in the classroom. The paraprofessional designated for supporting Lorelei tries her best to make her participate in the daily routine and in classroom activities as much as possible. In the classroom, there are seven different activity centers available for the children to play in and explore, all related in some way to the current unit of study. Reason for targeted intervention At the beginning of the school year, she was in my class for seven weeks until the Special Education department moved her to another campus with a new teacher. The other school had an ARD (Admission, Review and Dismissal) meeting because they were experiencing difficulties with her, and then they brought her back to the researcher at the end of March. B. Target/Replacement behavior The target behavior was to help the student stay on her tasks, i.e. to increase the frequency of on-task behavior. This was considered helpful to overcome her difficulty with change when she is given tasks she does not like doing. C. Baseline Data Data collection During the baseline phase, data was collected using time sampling for a period of 20 minutes each day during Loreleis center time. At the end of each time interval, which lasted one minute, an observation was made of whether Lorelei was on-task or not. Results Six sessions of baseline data were collected. During the baseline phase, the rates of off-task behavior ranged from 45% to 65% of the intervals observed. Lorelei was off-task for a mean of 9.7 out of the 20 one-minute time intervals in which data were collected. In other words, Lorelei was off-task for 49% percent of the time intervals. The greatest frequency of off-task behavior occurred on the last day of baseline session 6 where Lorelei was off-task for 65% of the time intervals observed. D. Functional Assessment Data collection The method of observation was mainly used for the functional assessment as well, and in the same manner as for the baseline data collection described above. A functional assessment was made of the student avoiding or escaping from situations while in a small group. This included noting when she engages in the behavior, i.e. what triggers it, and her reaction. Besides conducting direct observations of Lorelei throughout her school day, the data collection also involved interviewing Loreleis teachers. Purpose The purpose of the Functional behavior Assessment (FBA) was to identify the main setting events, namely the antecedent and consequent events while observing Loreleis behavior. Observation Antecedent event: This occurs when the student is asked to comply with a certain task which she chooses not to participate in. Consequent event: She becomes very frustrated and mad to the point that she will bang her head. She tries all she can to avoid the situation and to walk away to escape from the activity. Environmental stimuli: This observation was made in a very structured and routine environment. The student engages in the described behavior when a task is presented and the behavior ends when she is allowed to stop doing the activity. If the activity is not engaging enough for her, she refuses to comply. This behavior was observed to occur regardless of who gives her the task, and there are no noticeable skill deficits other than her communication difficulties, and it should be noted that she remained independent at all times. The student prefers playing with blocks over any other activity. In response to the aversive stimuli would be the demand put on her to do something that she does not want to do. E. Hypothesis The following hypothesis was formed and tested: The use of picture activity schedules reduces the frequency of off-task behavior and increases the frequency of on-task behavior in students with behavioral difficulties when facing a change or routine. F. Intervention Intervention design The intervention was made by scheduling a picture activity in which a laminated tan folder with velcro pictures was used of the seven centres in the front of the classroom. On the inside of the folder, there was space for three pictures with the numbers 1-3 next to them, and on the back was space for three tokens that Lorelei was told she could earn together with a picture of the reinforcer, which was chosen to be Dora the Explorer. The schedule was timed using a visual timer that had a clock face. As time passed, the red space representing the passing minutes became smaller to show how much time had elapsed and remained. The intervention design was characterised by being a single-subject A-B design, which was implemented to determine the effects of the intervention for Lorelei. Lorelei was considered to be on-task if she remained alert for at least 4 minutes out of a total of 7 minutes. In this way, Lorelei was made to work on increasing on-task behavior during her limited center time. On-task behavior and center time were regarded as follows: On-task behavior was defined as looking at the current activity with her eyes, using the materials given appropriately, keeping her hands to herself, and carefully following the teachers directions. Center time referred to the activity time allocated for students to engage in activities of their own free choosing that lasted approximately 60 minutes each day. Rationale The A-B design was chosen because the intervention was conducted within a classroom setting, and the researcher did not think it was appropriate to terminate the intervention and return to the baseline state. A withdrawal design was not therefore recommended due to the concern that any inappropriate behaviors displayed by the student might increase making her become disruptive. As for the period of seven minutes allocated to spend at each center, this was chosen because her teachers felt this was an appropriate amount of time she would be able to attend based on previous observations. The Dora the Explorer theme was chosen because it was recognised as being very motivating for Lorelei, and a puzzle based on Dora was put together by her frequently. G. Results Method The desired behavioral objectives were achieved by applying a Differential Reinforcement of Incompatible behavior Procedure (DRI) combined with the use of a picture schedule and token board activity. At the start of the center time, Lorelei was taken to a quiet corner accompanied by a teacher, and was asked to choose the three centers she was going to work on for the day. Photographs of the chosen classroom centers were on the front of her activity schedule. She then placed the three pictures next to the numbers 1-3 on the other side of her activity schedule. The other students in the class used a card system in which they waited for the name to be called who then walked up to the centers chart to make a choice in front of their peers as to which center they will choose first. However, this proved challenging for Lorelei because she often displayed inappropriate behavior, as described earlier, whilst the attention of her teachers and peers was solely on her. Planning with a teacher in a quiet spot in the classroom therefore proved beneficial for Lorelei, as this kind of attention was not allowed to disturb her. Lorelei placed the photographs of the chosen centers on the activity schedule board with the help of a teacher. She then proceeded to the first center where a teacher set a visual timer to run for seven minutes, which proved to be an effective way of showing Lorelei whenever a transition was approaching. Loreleis teachers called attention to the visual timer throughout her time at each center, and when the time was up, Lorelei was given a piece of a puzzle if she had been on-task for the majority of the one-minute interval at the center. When she was not on-task, she was not given a piece of the puzzle. These pieces she got were then put on the back of her schedule before moving on to the next center. Lorelei was also praised verbally by her teacher whenever she remained on-task. And, the teacher who worked with Lorelei gave suggestions every other minute of the appropriate language to use with the other children at the center. She was prompted to use such phrases as “want to play” and “can I have a turn”, and verbal praise was also given when these these phrases were used successfully with her peers. At times when Lorelei was not on-task for more than two minutes, she was redirected by a teacher who helped her to become engaged again in the activity by means of both verbal and physical prompting. After completing the third center, if Lorelei had earned three pieces of the puzzle, she was allowed to watch five minutes of a video clip featuring Dora the Explorer under supervision of a teacher. In cases when she did not receive the three required pieces of puzzle, she was allowed to take a sensory break of the teachers choosing and had to return to the classroom for the remainder of the center time. Functional behavior analysis A functional behavior analysis revealed some insightful information into Loreleis behaviors. Loreleis difficulty with modulating her level of arousal and her sensory defensiveness, as termed by an occupational therapist, impeded her ability to participate appropriately during many parts of the school day, including during the center time and other free choice activities. This condition manifested itself by her touching other students, turning off the lights, running around the classroom banging her head, and by what appeared to be attention seeking behaviors. Whilst Lorelei was playing at a center, she demonstrated some off-task behaviors in the form of inappropriate head banging and misuse of classroom materials to gain attention from peers and teachers. Lorelei’s off-task behaviors were usually head banging, running from teachers, and displaying aggressiveness. These problems occurred throughout the day, but most often during unstructured times of the day. If the behavior was not redirected, it could have lasted longer amounts of time. The behaviors were both disruptive and dangerous, and occurred in front all staff members. It was therefore decided that there was a sensory link to the function of the behavior, which caused her to exhibit her attention seeking behaviors. The FBA revealed that the negative behaviors occurred most frequently when Lorelei experienced sensory overload during unstructured parts of the day such as during center time, and that she was unable to monitor it. In addition, when Lorelei did not understand what was being taught during whole group time on the carpet, she would occupy herself by trying to get the attention of others by screaming or turning out the lights. Data analysis Data were collected for eleven days of the intervention stage. The rates of off-task behavior during the intervention phase generally ranged from 10% to 30% of the observed intervals. However, the lowest rate of off-task behavior occurred during the eighth and ninth sessions of the intervention stage when Lorelei was off-task for only 5% of the time intervals. This shows that her off-task behavior could be reduced a lot. Throughout the intervention stage, Lorelei was off-task for a mean of 4.1 out of the 20 one-minute intervals, or 20% of the intervals. The days on which data were collected spanned over a month and a half. Due to external factors such as absences and therapy sessions, the days on which data were collected did not follow one after the other consecutively. Despite these factors, Loreleis off-task behavior decreased from baseline to intervention, and in turn, her on-task behavior increased as well. The table below summarises the quantitative data for both the baseline and intervention phases for comparison. Baseline phase Intervention phase change Frequency of off-task behavior (%) Min. 45 5 89% decrease Max. 65 30 54% decrease Mean off-task rate during 20-minute interval (%/raw) Mean 49 20 59% decrease Mins 9.7 4.1 Reduced by 5.6 mins Sessions/Days of data collection 6 sessions 11 days (non-consecutive) - The percentage data for the two phases is illustrated on the chart below. All three frequencies (minimum, maximum and mean) for off-task behavior declined as a result of applying the intervention (so the hypothesis was upheld): The frequency for minimum off-task behavior reduced from 45% to 5%, which was a reduction of 89%. The frequency for maximum off-task behavior reduced from 65% to 30%, which was a reduction of 54%. The frequency for the mean proportion of off-task behavior reduced from 49% to 20%, which was a reduction of 59%. In terms of actual time, the mean reduced from 9.7 minutes (out of the 20 one-minute intervals) to 4.1 minutes, which was a reduction by 5.6 minutes. H. Reflection Effectiveness of the intervention The results of this intervention support previous research on the effectiveness of using picture schedules for students with autism in order to help increase the frequency of on-task and appropriate classroom behavior. In this study, a DRI was used to decrease the frequency of off-task behavior, and thereby increase that of on-task behavior for a four-year-old girl with developmental delay. There was an immediate increase in the frequency of on-task behavior from baseline to the intervention stage. The effectiveness of visual activity schedules was confirmed in a study by Bryan & Gast (2000) with a similar A-B withdrawal design in which the students performances were able to be maintained. The schedules were shown to promote “the independent functioning of students with autism spectrum disorders in their least restrictive environments”. It has also been confirmed in more recent studies, such as by Schneider & Goldstein (2010) in an inclusive classroom context, and in a meta-study (of 18 other studies) by Lequia et al. (2012). Moreover, Meadan et al. (2011) have identified various kinds of helpful visual supports that teachers can use in their classrooms, and Krantz & McClannahan (2014) have shown the strategy to be most effective for promoting on-task behavior, and also diminishing prompt dependence, when it is used throughout the day in various settings and with different adults. Overall impressions If a similar intervention was to be made to target the same kind of behavior as was exhibited by Lorelei, it may be beneficial for the positive reinforcements to occur immediately after each center, instead of being deferred until the completion of all three centers. The pieces of puzzle themselves were not as motivating as actually watching the video. One concern of the researcher though was that the participant did not seem to associate the on-task behavior from the beginning of the center time with the reward at the end because when the student was off-task for some of the intervals in the last center, she still earned a reward if she had done well in the previous centers. By examining the effects of the intervention, the researcher also became aware of certain environmental aspects of the classroom and centers that made it challenging for Lorelei to stay on-task. Due to her sensory processing difficulties, centers such as the block area and the dramatic play area, were very hard for Lorelei to concentrate in and to stay on-task. She was more successful in quieter centers such as the library and the art studio. Also, when Lorelei was working with her one-on-one paraprofessional, she was able to stay on-task for a longer amount of time than when she was with the researcher alone. It is also interesting to note that Lorelei worked well with certain students compared to others. Before starting the intervention, it would have been beneficial to record exactly how long Lorelei spent at each center. It could also have been insightful to let Lorelei go through the centers for a period of time by herself. She is rarely without a teacher by her side for safety reasons, but stepping back and observing how she interacts with peers on her own without a teacher standing by may have been interesting and useful to note. Future possibilities Nonetheless, the success of this intervention suggests that the strategy of using a picture schedule during more unstructured parts of the day could be beneficial for students who need more guidance and structure. The schedule was easy to implement and inexpensive to make, and could be helpful for other students with similar behavioral and learning difficulties. Moreover, this is an intervention that can be used across a range of classes and age levels. It is important to keep in mind that the reinforcement plans must be concise and immediate, contingent on the appropriate behaviors. In the future, it may be useful to have students collaborate in teams, and use a schedule together. In an inclusive classroom such as Loreleis, this could be an appealing strategy. Having Lorelei and a peer work together to decide what centers they will visit, and to do this together in mutual agreement, could help Lorelei work on developing the much needed social skills as well as in habitually staying on-task. Overall, picture schedules can help students with sensory and attention difficulties navigate successfully through the school day. As this study confirms, and the brief review of previous studies also showed, picture activity schedules do have the potential to help autistic students with behavioral difficulties. The change in the frequency of on-task behavior by Lorelei as result of the intervention was significant. The study also demonstrated the suitability of least restrictive environments, i.e. the same settings as for students without disabilities. The future possibilities for such an intervention are promising. It is recommended to promote this kind of intervention program in Texas and elsewhere. References Bryan, Linley C. & Gast, David L. (2000). Teaching on-task and on-schedule behaviors to high-functioning children with autism via picture activity schedules. Journal of Autism and Developmental Disorders, 30(6): 553-567. Krantz, Patricia J. & McClannahan, Lynn E. (2014). Picture activity schedules. Handbook of Early Intervention for Autism Spectrum Disorders, Autism and Child Psychopathology series, pp. 345-373. New York, Springer. Lequia, Jenna; Wendy Machalicek & Mandy J. Rispoli. (2012). Effects of activity schedules on challenging behavior exhibited in children with autism spectrum disorders: a systematic review. Research in Autism Spectrum Disorders, 6(1): 480-492. Meadan, Hedda; Michaelene M. Ostrosky, Brooke Triplett, Amanda Michna & Angel Fettig. (2011). Using visual supports with young children with autism spectrum disorder. Teaching Exceptional Children, 43(6): 28-35. Schneider, Naomi & Goldstein, Howard. (2010). Using social stories and visual schedules to improve socially appropriate behaviors in children with autism. Journal of Positive behavior Interventions, 12(3): 149-160. Read More