Aggressive BehaviorsThank you soooooooooooo much!!!!! I hope you were able to cut and paste that in from somewhere  . The suggestions sound alot like the way my son's IEP was phrased in the past. I guess the challenge is getting someone in the classroom to provide these prompts and reinforcers. Again thatnks for your imput I really appreciate it!!!!! It sounds like that's exactly what he needs but I will never get it from the school...No way!!! I even have an attorney! They claim he doesn't need all these supports.  I am not sure if any person like this even exists in my area Since these FABULOUS supports are not available to my child for some reason, I guess I started this post to get ideas about specific strategies that work for your kids...like what are these intervention techniques, and non-aversive behavioral change methods? We don't get it from the school, the school doesn't provide wraparound. We had to go through a community service group through the local intermediate unit. I'll share with you Ky's treatment plan from her BSC it's long but just to give you an idea: Problem Behavior # 1 Safety risk behaviors Baseline Behavior(s): (Must include frequency, intensity, duration and setting.) Kylie demonstrates an attempt to elope and non-compliance with safety directions on average of less than one time per day across settings with the range being 0 to 4. The intensity is low to moderate and the duration is 5 to 10 seconds. Kylie did accompany her class on a field trip to the zoo in May 2009. The data indicated that she demonstrated the highest frequency of safe behavior in this setting compared to her classroom or home. During the recent break between school and ESY, Kylie also demonstrated the need for prompting to encourage awareness of sidewalks and needing to be with a caregiver before stepping out into the parking lot. Trend lines indicate progress as her target behaviors are low and stable and her replacement behaviors are increasing. Target Behavior: (must be measurable) Attempts to elope, non-compliant with safety directives Objectives: (Must be measurable.) When in the community, Kylie will respond to safety directions with no more than one verbal prompt and will remain with caregiver in the absence of having her hand held. Replacement Behavior: (must be measurable) Remain with caregiver, compliance with “stop” and “come here” Methods: (Must be specific and detailed, including but not limited to client/family strengths to be utilized and who is responsible to provide the intervention.) Parent/TSS: Continue to provide Kylie with opportunities to participate in community outings. Focus on locations that have historically resulted in tantrum behavior or non-compliance. Parent/TSS: Remind Kylie of the expectations prior to entering a safety demanding safety situation. TSS: Utilize verbal prompting as well as blocking (standing between Kylie and the safety demanding situation) to redirect her target behavior. Parent: Hold Kylie’s hand if she is not responsive to the verbal prompting/blocking. Problem Behavior # 2 Non-compliance with directions Baseline Behavior(s): (Must include frequency, intensity, duration and setting.) Kylie demonstrates significant difficulties transitioning between activities, completing tasks, and following directions. Kylie has demonstrated progress regarding this goal. She currently demonstrates non-compliance with aggression on average of 7 times per day (range of 0 to 34) with a low to moderate intensity indicative of her responsiveness to redirection and with a duration of 5 to 30 seconds. Target Behavior: (must be measurable) Non-compliance with directions, aggression Objectives: (Must be measurable) Kylie will comply with task directives and transitions with no more than one prompt and in the absence of physical and verbal aggression. Replacement Behavior: (must be measurable) Compliance with directions with no more than one prompt (and in the absence of aggression) Methods: (Must be specific and detailed, including but not limited to client/family strengths to be utilized and who is responsible to provide the intervention.) Teacher/Parent: Provide the initial direction either in a group or individual format. TSS: Provide prompting to ensure compliance if Kylie has not begun to comply within 3 to 5 seconds. Utilize the least intrusive prompt, beginning with a gestural prompt. Avoid providing verbal prompts as these are more difficult to fade. BSC/Teacher/Parent: Identify items/activities/food that Kylie finds reinforcing. Teacher/Parent/TSS: Vary reinforcers so that they remain “fresh”. It will be important too to keep reinforcers for times of compliance. For example, if she finds Goldfish crackers reinforcing, she will only get these when she has demonstrated compliance; these will not be used for snack time. TSS/Teacher: Continue to utilize the token system. Parent/TSS/Teacher: Continue to remind Kylie of her need to have a “quiet voice” and “quiet hands”. Problem Behavior # 3 Impaired social skills Baseline Behavior(s): (Must include frequency, intensity, duration and setting.) Kylie has demonstrated progress in regard to this goal. She does continue to demonstrate isolated play with aggression on average of 1 to 2 times per day with a range from 0 to 9. The intensity is moderate indicative of marks left on peers and a duration of 3 to 10 seconds. The decreasing trend for target behaviors indicates progress. The decreasing trend for replacement behaviors likely occurred as a result of her progress with parallel play. She currently demonstrates parallel play with aggression on average of 1 time per week with a moderate intensity indicated too by marks left on peers and a duration of 3 to 10 seconds. The decreasing trend for target behaviors indicates progress as does the increasing trend for replacement behaviors. Target Behavior: (must be measurable) Isolated play, aggress towards peers Objectives: (Must be measurable.) Kylie will engage in parallel play with peers in the absence of aggression. Replacement Behavior: (must be measurable) Parallel play in absence of aggression Methods: (Must be specific and detailed, including but not limited to client/family strengths to be utilized and who is responsible to provide the intervention.) Teacher/Parent/TSS: Join Kylie’s play scheme and encourage engagement. Encourage her to expand her play scheme (offer new ideas). Reinforce her for tolerating adult intrusion in her play. Teacher/Parent/TSS: Provide Kylie with opportunities to imitate the actions of adults during structured situations. Provide a high level of reinforcement and hand-over-hand prompting faded to independence in order to encourage compliance with requests to imitate adults. When she is fluent in imitating adults, encourage her to imitate peer’s actions, again, with a high level of reinforcement for this new and more challenging request. Teacher/Parent/TSS: Provide opportunities for Kylie to practice turn taking and sharing with adults. Provide a high level of reinforcement when she is tolerant with demand to give up a preferred item for only seconds initially. BSC/Teacher: Consult with Kylie’s speech therapist in regard to visual icons that may be beneficial in requesting items from others. Problem Behavior # 4 Difficulty expressing needs Baseline Behavior(s): (Must include frequency, intensity, duration and setting.) Kylie can “mand” or request items in full sentences. She is not able however, to effectively convey her emotions, internal states or more abstract needs. This leads to frustration and tantrum behavior. Kylie demonstrates tantrum behavior multiple times per day during which she scratches herself, and bites and scratches others as well as swears. She does demonstrate crying, whining and screaming on average of 67 times per day with a low to high intensity and with a duration of 5 seconds to 3 minutes. She does demonstrate aggression towards others and items on average of 15 times per day as well as SIB on average of 5 times per day. She does express her wants and needs on average of 58 times per day. Kylie will demonstrate staring behavior that is being addressed by a neurologist. When she demonstrates these staring episodes, she will often engage in tantrum behavior afterwards (screaming, scratching, biting herself, throw herself on the floor and roll around). These occur across settings multiple times per day of an intensity 10/10 lasting 10-30 minutes. The team has also observed correlation between Kylie’s tantrum behavior and hunger and is addressing this issue. Target Behavior: (must be measurable) Cry/whine/scream, aggress towards others or objects, SIB (scratch, bite self) Objectives: (Must be measurable.) Kylie will comment in addition to request in absence of frustration and/or tantrum behavior. Replacement Behavior: (must be measurable) Convey/comment on emotions, internal states and/or more abstract needs. Methods: (Must be specific and detailed, including but not limited to client/family strengths to be utilized and who is responsible to provide the intervention.) Teacher/Parent/BSC: Consult with Kylie’s speech therapist to ensure consistency in application of interventions. Parent/Teacher/TSS: Provide Kylie with a verbal model of appropriate requests or protests. Reinforce her for using appropriate, calm statements. BSC: Continue to develop structured programs for team to use at home in order encourage Kylie to practice commenting on presented materials. Parent/Teacher/TSS: To the best of your ability, label the emotion and internal state demonstrated by Kylie (hunger, thirst, sad, happy, etc). Parent/TSS/Teacher: Continue to log each meal/snack that Kylie consumes each day and indicate the behavior that was observed after each meal/snack. This log should be completed across all settings to ensure collaboration. TSS should note food and behavior as well. Parent/Teacher/TSS: Kylie may ask for a snack or indicate hunger. At this point, it is clinically appropriate to fulfill each of her requests. This can be faded after time to encourage delays between her request and her receiving the food. There may be times too, when Kylie is not able to request but her behavior starts to deteriorate. At these low level behaviors (whining, change wording to "I need..." repeatedly), food should be offered prior to an escalation. Model an appropriate request for Kylie and reinforce her with a snack. Kylie has also shown that she is hungry after physical activity. It would be ideal for her to be prompted to ask for a snack at the conclusion of such activities as swimming, exercise in the gym, taking a walk, etc. It would be ideal for the meals/snacks that are offered to Kylie be ones that would stay with her for longer periods of time, such as vegetables, nuts, raisins, fruit and meats/dairy. Snacks should be provided from home in her lunch bag daily or sent in for the week to be kept in the classroom refrigerator. When TSS observes Kylie to demonstrate low level behaviors or if Kylie makes a request directly to TSS, TSS will redirecect Kylie to the teacher/aide and will provide a verbal model such as "Ms. C, I need a snack." Ms. C/aide would then provide Kylie with the snack. Nature of Concern: Kylie demonstrates significant difficulties transitioning between activities, completing tasks, and following directions. Kylie demonstrates tantrum behavior multiple times per day during which she bites, scratches, and swears. Step 1: Strategy to be used when child/adolescent is exhibiting low-level problematic behavior (i.e., observe, monitor, ignore, back off, indicate displeasure, etc.) Action to be taken: Provide clear, concise directives in a “first, then” format. Provide a high level of reinforcement for spontaneous compliance. Remind Kylie of expected behavior. Assess behavior for likelihood of hunger. Step 2: Strategy to be used when brief/minimal response may stabilize (i.e., convey empathy, offer assistance, humor to diffuse, provide options, remind of reward/consequences, redirect, etc.) Action to be taken: Utilize the token system and provide tokens for appropriate behavior. Encourage Kylie to request a snack from a caregiver. Step 3: Strategy to be used when the issue is personal safety (i.e., elicit assistance of adult present; instruct others to leave area; instruct child/adolescent to remove him/her self until (s)he has regained control; provide clear; concise directions for appropriate; state consequence of behavioral; leave). Action to be taken: When Kylie is at risk for harming herself or others, teacher/parent/TSS should escort her to a safe quiet place in order to encourage her to calm and to avoid inadvertently reinforcing her tantrum behavior. I agree with getting an FBA/BIP. It is an assessment of why a student has a certain behavior (what function does that behavior have for him) and how to teach the student to communicate his need in a more appropriate way. For example if he hits when he sees another student with a desired object and the function is to get the object for himself, the teacher needs to focus on teaching him to ask for what he wants. If he punches because he becomes overwhelmed by too little structure during playtime and too much stimulation the teachers need to figure provide him with more structure and a way to communicate that he is getting overwhelmed and needs a break in a quiet corner. I hear teachers say that our kids use agression to get their way but I really think that is completely oversimplyfied. Our kids lack the skills to deal appropriately with situations that same age peers can deal with and they need to be taught the skills. If the school has not already done an FBA ask for them to do one and have an experienced person take the lead on that. [QUOTE=curzir]My son Evan in 5 and in an inclusion kindergarten class with 12 students. 1/2 of the kids have IEP and 1/2 are regular Ed. There are no other kids on the the spectrum. He is pretty high functioning and good with his academics. He has a hard time relating to his peers even though he is very verbal. One of the main problems I have with Evan is his aggressive behavior when he does not get his way. Last week another student was playing with what he wanted to play with and he punched him. Although he has other problems with transitioning to less preferred activities this aggression thing in a HUGE problem since I am afraid they will remove him from that classroom and back to a sub separate classroom like he was in before with all non verbal students... Any advice on some startegies that can change this lack of impulse control?? [/QUOTE] what about a social storey on hitting .i use to be aggressive to at school when litte an litte at home but not like in school .i pinch when got really frustred .it only happens now if im really in super overload an cant say what wrong My son Evan in 5 and in an inclusion kindergarten class with 12 students. 1/2 of the kids have IEP and 1/2 are regular Ed. There are no other kids on the the spectrum. He is pretty high functioning and good with his academics. He has a hard time relating to his peers even though he is very verbal. One of the main problems I have with Evan is his aggressive behavior when he does not get his way. Last week another student was playing with what he wanted to play with and he punched him. Although he has other problems with transitioning to less preferred activities this aggression thing in a HUGE problem since I am afraid they will remove him from that classroom and back to a sub separate classroom like he was in before with all non verbal students... Any advice on some startegies that can change this lack of impulse control?? Does he have a Functional Behavior Assessment for his IEP/positive behavior plan? This has really helped us for our daughter. Well the school has done an FBA in the past and made a BIP however I did not find any improvement whatsoever. That was last year when he was in the sub-separate class and he was working with an excellent teacher who was trained in ABA and was very aware of how to deal with kids on the spectrum. She also had more support with 2 paras to only 7 students. Even then I feel that a BIP is only functional when someone is available to take data, and constantly be aware of what really triggers these behaviors. In this case there is not someone available since there is only 1 aide at a time and there are several different aides throughout the day none of which are familiar with the specific difficulties of kids on the spectrum. When I suggested he have a 1 to 1 aide who was trained to deal with kids on the spectrum at the IEP meeting the group looked at me as if I asked if he could bring a gun to school.Also, he does have the skills to ask for what he wants, but sometimes getting his way is just not an option and he lashes out physically because he is angry about that. He knows hitting is wrong and feels bad afterward. Have you had any experience with an FBA or a BIP actually working? any tips ? Your son might just benefit with what my daughter has and that is wraparound services. She gets a TSS and BSC. My daughter is in Autistic support and inclusion. The FBA we had through pre-k has since changed with having our BSC redo it since she is now in kindergarten. We use alot of positive reinforcement and "quiet voice", "quiet hands", "push the wall". When she gets too aggressive to the point where nothing works we just remove her to a safe spot and let her calm down. [/QUOTE] Sorry...can you explain what is wraparound services and TSS and BSC? I have never heard those terms before  ..Thanks! I appreciate your responses.TSS is Therapeutic Staff Support provide one-on-one interventions to a child or adolescent at home, school, day care, other community-based programs. BSC is a Behavior Specialist Consultant. The BSC identifies behavioral goals and intervention techniques, and recommends non-aversive behavioral change methods. The BSC provides direct supervision and consultation on the implementation of treatment to Therapeutic Staff Support (TSS) and Mobile Therapist (MT) assigned to the case. They work in collaboration with other members of the treatment team, designs, directs, and evaluates the implementation of the treatment plan which is individualized to each child and to family needs. |
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