Family-centered PBIS

Family-centered PBIS for Young Children and Its Process

Family-centered positive behavior support refers to PBIS conducted within a family environment where the family not only partners with professionals to design and implement behavior support for a child with challenging behavior, but also where the family unit is viewed as the primary beneficiaries and as the primary decision makers. The family-centered PBIS is facilitated by a professional, or team of professionals, with expertise and experience in: (1) assessment and intervention strategies of PBIS; (2) early childhood development and early intervention, and; (3) family functioning, family systems and cultural differences. The process can be described as consisting of five major steps.  These are described below.

STEP 1:  Teaming and Goal Setting.  
1) Establishing relationship between professional and families    
The first step in family-centered PBIS is establishing a trusting relationship between the professional and the pertinent family members.  Building a strong rapport with the family is key to a successful PBIS process because a relationship characterized by trust and candor can greatly facilitate the assessment and intervention process.  The professional must listen and be responsive to the family members concerns and priorities and interact with respect and honesty (Keen, 2007).  The relationship should strengthen over time, but often the initial few meetings set the tone and determine the course that future interactions will take.  Many families, even those with young children, have experienced disappointing interactions with service agencies and professionals, so trust and openness cannot be assumed.  The desired relationship of mutual respect and partnership has to be developed.

2) Team development
A second priority is the development of a team that will work with the family to develop and implement the PBIS plan.  The team should consist of those individuals who are connected to the child and family, and who are involved and invested in the child’s healthy development.  Teams always include the child’s parents (or those filling parenting roles), and often include extended family members, close friends, teacher(s), therapist(s), consultants (including the PBIS professional), and administrators.  Well-functioning teams bring numerous advantages to the PBIS process.  They offer multiple sources of knowledge, multiple perspectives on the child’s development and behavior, and resources that may be useful in implementing PBIS.

3) Setting short-term and long-term goals
Setting goals is to create a shared vision so that all team members agree on the desired outcomes for the coming few months as well as for longer periods of time (such as one year, two years, and/or entry into kindergarten). While the first meeting serves to build the team through a process of developing goals for the child and family, the second meeting usually includes some celebration regarding progress that has occurred, a reconsideration of goals, possible revisions to the plan, and a renewal of the team’s commitment to the child and family.  Subsequent planning meetings are then scheduled on a periodic (e.g., annual) and as-needed basis to revisit the supports needed by the child and family, to establish new goals, and add new team members.

Step 2: Functional Behavioral Assessment.
The purpose of the functional behavioral assessment is to operationally define the challenging behaviors in all of the contexts in which they occur, identify the function or purpose of the behavior from the child’s perspective, and specify the specific antecedent conditions associated with high and low probabilities of the behavior occurring.

A primary outcome of the functional assessment process is a set of hypothesis statements that summarize the assessment results for each relevant behavior and each distinctive routine.  A hypothesis statement specifies the context, the behavior, and the behavior’s function.  For instance, one statement might read: “When asked or prompted to come to the dinner table, Jenny will fuss and occasionally scream or throw objects in order to escape the request and remain in her ongoing activity.”  Another example might be: “When Terrell is left alone for 15 minutes or more, he is likely to hit one of his classmates or disrupt their play activities in order to obtain attention from one of the adults in the classroom.”  Hypothesis statements are very useful because they suggest intervention components that address the antecedent conditions under which challenging behaviors occur, and they suggest instructional objectives to serve as alternatives to the behavior challenges.

STEP 3: Developing the PBIS Plan.
The PBIS plan is developed as a collaborative process by the core members of the team, including those who will be responsible for its implementation.  The plan components are based on information provided by: (1) the functional assessment; (2) the goals established during the initial planning process; (3) all other available information about the child, and (4) team members’ opinions regarding the feasibility of consistent implementation (Albin et al., 1996).

1) Prevention component
A setting event is an occasion or circumstance that increases the likelihood that challenging behavior will occur.  For instance, for one young boy, the absence of a comfort item (a blanket) produced stress that increased the likelihood that a subsequent request (to get ready for school) would be followed by a tantrum.  A prevention intervention was to consistently place the blanket in a predictable location, where the boy could find it. Antecedent events are any actions that evoke challenging behavior or, alternatively, desirable behavior.  In a previous example, being called to dinner was an antecedent event that produced Jenny’s fussing.  Antecedent stimuli can be requests or demands, materials, the presence of particular people and even odors, sounds, and tactile events.  In school settings, antecedent events are often part of the instruction and curriculum (Dunlap & Kern, 1996; Dunlap et al., 1991).

2) Intervention component
Interventions involve removing or ameliorating antecedent stimuli associated with challenging behavior and adding antecedent events associated with desirable behavior.  Additional prevention strategies include picture schedules, social stories, pretask requesting, and similar techniques designed to make the environment more predictable and comprehensible (Crimmins, Farrell, Smith, & Bailey, 2007; Kern & Clarke, 2005; Westling & Fox, 2004).

3) Teaching component
The “teaching” component involves identifying an instructional objective and making arrangements to provide instruction on the new target behavior during pertinent times of the day.  A major purpose is to develop an alternative to the challenging behaviors so that the child no longer needs to engage in challenging behavior in order to achieve the purpose (function) of the behavior.  The term for this type of assessment-based instruction is functional communication training (FCT), which was originated by Carr and Durand (1985).  In the past 20 years, FCT has been replicated and extended numerous times and its efficacy has been demonstrated with various populations, including toddlers with behavioral challenges (Dunlap, Ester, Langhans, & Fox, 2006).  In addition to function-based communication, there are numerous other skills that can be taught to an important behavioral advantage.  Self-regulation and self-management, social skills, independence, cooperative play, and emotional literacy are all worthwhile objectives that can yield gains in behavioral adaptation and that can be fruitful elements of the PBIS repertoire.

4) Reinforcement component
The “reinforcement” component simply means using the principles of contingency management and positive reinforcement to their best advantage.  Challenging behaviors often arise because the child obtains inadequate reinforcement in the course of unplanned daily interactions.  Therefore, it is important in any PBIS plan to provide for some alteration in the way in which reinforcers are delivered.  This may involve a systematic preference assessment, enhancement of noncontingent reinforcement (and environmental enrichment), and care to see that challenging behaviors are not inadvertently rewarded.

5) Additional components
Structural changes in a child’s daily routine: For instance, it may be advisable to change preschool classrooms to one that provides more consistent encouragement of social interaction and communication, or it may be useful to add structured play groups or to remove unnecessary or unproductive therapies from an already overcrowded schedule.

Family support plan: For instance, respite might be an important service for parents, as might counseling, financial planning, or additional advice on medical care.

STEP 4:  Implementation.
Implementation of the PBIS plan often requires explicit assignments and supports.  Training in the form of coaching and support within the target routine or setting may be required for personnel, including parents, to effectively use some techniques indicated in the plan.  In addition, it is often useful to provide for written scripts of how to conduct routines, and prompts (such as schedules, cue cards, and chceklists) to help remind teachers and parents to deliver instruction and reinforcers on schedule.  It is important to always remember that even the most thoughtful and precise plan will be ineffective if it is not implemented with adequate consistency and integrity.

STEP 5: Evaluation, Refinement, and Follow-up.
Evaluation is an essential element in the implementation of PBIS.  The team should identify the highest priority behaviors, settings, and outcomes and formulate efficient methods of data collection in order to determine if sufficient progress is occurring.  In most cases, ongoing direct data collection is not feasible, so we frequently recommend the use of 5 or 6-point rating scales with clear anchors.

The purpose of the evaluations of child performance and implementation fidelity is to determine if changes and refinements need to be made to the plan.  It is common for this to be the case.  If behavior is not changing as rapidly as expected, adjustments can be made.  Occasionally it is found that certain components are not being implemented.  If so, it is necessary to learn the reason and either add prompts or other cues to increase fidelity or make adjustments to the components to make it more likely that they would be implemented.

References

Albin, R. W., Lucyshyn, J. M., Horner, R. H., & Flannery, K. B. (1996).  Contextual fit for behavior support plans: A model for a “goodness of fit.”  In L. K. Koegel, R. L., Koegel, & G. Dunlap (Eds.), Positive behavioral support: Including people with difficult behavior in the community (pp. 81-98).  Baltimore: Paul H. Brookes.

Carr, E.G., & Durand, V.M. (1985). Reducing behavior problems through functional communication training. Journal of Applied Behavior Analysis, 18, 111-126.

Crimmins, D., Farrell, A. F., Smith, P. W., & Bailey, A. (2007).  Positive strategies for students with behavior problems.  Baltimore: Paul H. Brookes.

Dunlap, G., & Kern, L.  (1996).  Modifying instructional activities to promote desirable behavior: A conceptual and practical framework.  School Psychology Quarterly, 11, 297-312.

Dunlap, G., Ester, T., Langhans, S., & Fox, L.  (2006).  Functional communication training with toddlers in home environments.  Journal of Early Intervention, 28, 81-96.

Dunlap, G., Kern-Dunlap, L., Clarke, S., & Robbins, F. R. (1991).  Functional assess-ment, curriculum revision, and severe behavior problems.  Journal of Applied Behavior Analysis,24, 387-397.

Keen, D. (2007).  Parents, families, and partnerships: Issues and considerations.  International Journal of Development, Disability and Education, 54, 339-349.

Kern, L. & Clarke, S.  (2005).  Antecedent and setting event interventions.  In L. M. Bambara and L. Kern (Eds.), Individualized supports for students with problem behaviors: Design-ing positive behavior plans (pp.201-236). New York: Guilford Press.

Westling, D. L. & Fox, L.  (2004).  Teaching students with severe disabilities, 3rd edition.  Upper Saddle River, New Jersey:  Pearson Education, Inc.