Positive Behaviour Support and Quality of LifeMaryam Roghani
EPSE 590
Positive Behaviour Support and Quality of Life for a Young Man with Autism
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About Me
I was born in Iran and moved to Italy at the age of 4 where I grew up with my family
I moved to Canada in 1998 and continued my education in Performing Arts majoring in guitar
While I was studying I was also working as a Behaviour Interventionist with children with autism
This is how I discovered my passion for
the field of special education…..
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Why M.Ed.
I currently work as behaviour consultant with adults and children over the age of 6
I decided to pursue my Masters in Special Education with a focus in Autism
I am also working to become a Board Certified Behaviour Analyst (BCBA)
UBC had the perfect program for me and my goals…
I decided to pursue my Masters in Special Education with a focus in Autism to increase and expend my knowledge in positive behaviour support and early intervention
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My Presentation
One M.Ed. Program Goal: to create evidence based Positive Behaviour Support
My presentation will review how the implementation of a PBS plan affected the Quality of Life of a young man with autism living in a group home setting
One of my goals while pursuing my Masters was to improve my knowledge and skills in creating contextually appropriate, person centered, and evidence based Positive Behaviour support plans
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What is Positive Behaviour Support?
“Positive behavior support (PBS) is an applied science that uses educational and systems change methods (environmental redesign) to enhance quality of life and minimize problem behavior.” (Carr et. al. 2002)
Positive Behavioral Support (PBS) is an empirically validated, function-based approach to eliminate challenging behaviors and replace them with prosocial skills.
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emotional well-being
interpersonal relationships,
material well-being
personal development
physical well-being
social inclusion and rights
Schalock (2002) defined quality of life as a concept that reflects the desired conditions in eight life dimensions:
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Positive Behaviour Support and Quality of Life
Research question: does quality of life for individuals with autism increase as problem behaviours decrease?
Data on behaviour and quality of life indicators for a young adult with autism reviewed:
Pre intervention
Post intervention
Likes a predictable routine
Likes activities that provide sensory input (swimming, music, taking a bath)
Likes independence
Self-injury
- Hits his nose with open hand with enough force to cause bleeding
Physical Aggression towards staff
- Hits staff with open hand. Can be hard enough to cause injury
Ritualistic/Repetitive Behaviour
- Repetitive opening and closing of shelf doors, laundry machine door, and fridge door for long periods
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Prior to implementation and during baseline data collection (November 2010-May 2011):
12 Critical Incidents
5 incidents with use of physical restraints
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Summarized:
2) Total number of activities for each life domain
3)The variety of activities in John’s schedule (location and topography)
4)The level of support needed for each activity and
5)Mood and medication charting
6)The level of participation
Function(s) included: Tangible
Designed and implemented a behaviour support plan (BSP) with these main elements:
Increase fit between John’s current schedule and his personal profile
Functional Communication Training
Weekly schedule with a portable visual schedule component
Redirect John to communicate his needs using his communication board if he shows signs of escalation
Provided training to staff for BSP implementation
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Self determination
Personal Development
Interpersonal relationships
12 Critical Incidents 6 incidents 1 inciden 0
20 Incidents 2 CIR 1 CIR 0
Maximum daily dosage of PRN medication 3 a month 17 repetetive beh 0
5 incidents with use of physical restraints
June-December 2011
2 Critical Incidents
6 Low-intensity Incidents
*Provide a title for the graph.*
1 Critical Incident
1 Low-intensity Incident
2 physical restraints
Medications become part of Health Care plan; one dose administered to manage anxiety
Team is fully implementing all components of PBS plan
0 Critical Incidents
0 Low-intensity Incidents
January 2013 - March 2015
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Choices: Use visual schedule to plan for his day
picking his own clothes
etc
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Self-Determination
Baseline Phase 1 and Phase 2 Phase 3 2013 2014 23 27.5 65 107 179.8
Monthly Average number of Activities
Personal Development: Baseline-Implementation-Follow Up
Activities fostering Personal Development
Personal Development Baseline Phase 1 and Phase 2 Phase 3 2013 2014 90 88.5 93 123 211
Monthly Average number of Activities
Interpersonal Relationships: Baseline-Implementation-Follow Up
Activities that foster relationships such as visiting peers, going home for weekend, bowling, swimming accessing places in community
Level of participation increase in terms of time spent doing activities
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Activities fostering Interpersonal Relationships
Social participation Baseline Phase 1 and 2 Phase 3 2013 2014 80 98 97 97 97
Monthly Average number of Activities
Social Inclusion and Rights: Baseline-Implementation-Follow Up
Number of activities in community/ variety of activities
e.g. going to different restaurants
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Activities fostering Social Inclusion and Rights
Social Inclusion and Rights Baseline Phase 1 and 2 Phase 3 2013 2014 37 48 44 53 80
Monthly Average number of Activities
Emotional Wellbeing Baseline-Implementation-Follow Up
Emotional Wellbeing: Anxiety Levels
Emotional Wellbeing Baseline Phase 1 and 2 Phase 3 2013 2014 35 47 32 17 1
Number of Stage 3 Incidents
Physical Wellbeing: Baseline-Implementation-Follow Up
Number of PRN for Pain
PRN for Pain Baseline Phase 1 and Phase 2 Phase 3 Follow up 25 16 5 5
Material Wellbeing: Baseline-Implementation-Follow Up
Activities fostering Material Wellbeing
Material Wellbeing Baseline Phase 1 and 2 Phase 3 2013 2014 6 5.3 6.2 6 6.6
Monthly Average Activities
Quality of Life
Speaking in 3 word utterances
Using self restraint if needed, by holding hands together on his back
Self-Determination
Makes choices of activities to plan in his day, very independent (cleaning, laundry, cooking)
Physical well-being
More active, less anxious and relaxed
He does not have any more pain/inflammation in his joints due to excessive pacing all day
Community and Leisure
Quality of Life
Rights
Lives in an environment where they honour his rights and treat him with respect, dignity, and equality
Social Inclusion
Goes bowling, shopping, to the library
Participates in activities with roommates and peers at home and in the community
Does not solely seek alone time
References
Carr, E.G., Dunlap, G., Horner, R., Koegel, R.L., Turnbull, A., Sailor, W., et al., (2002). Positive Behaviour Support: Evolution of an Applied Science. Journal of Positive Behavior Support, 4, 4-16.
Malette, P., Mirenda, P., Kandborg, T., Jones, P., & Rogow, S. (1992). Application of a lifestyle development process for persons with severe intellectual disabilities: A Case Study Report. Journal of the Association for Persons with Severe Handicaps, 17, 179-191.
Risley, T. (1996). Get a life! Positive behavioral intervention for challenging behaviour through life arrangement and life coaching. In L. K. Koegel, R.L., Koegel, & G. Dunlap (Eds.), Positive Behavioral Support: Including People with Difficult Behavior in the Community (pp. 425-437). Baltimore, MD: Paul H. Brookes Publishing Co.
Schalock, R. L., & Alonso, M. A. V. (2002). Handbook on quality of life for human service practitioners. American Association on Mental Retardation.
References Cont.