Positive Behavior Support: Changes That Last Jane I. Carlson, PhD, BCBA Autism Center of Virginia...
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Positive Behavior Support:Changes That Last
Jane I. Carlson, PhD, BCBA
Autism Center of Virginia
Virginia Commonwealth University
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Historical Perspective
Internal Validity Experimental Control Statements of
Causation
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New Perspective
External Validity Lifestyle Change Practical and Relevant Long-term Change
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6-year Longitudinal Study
Goals: Demonstrate Effectiveness of PBS
Implementation by Key Stakeholders
Long-term Maintenance of Effects
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Criteria for Inclusion
Severe Problem Behavior Excluded from Community Activities Required Physical Restraint or Medical
Attention Some Communicative Ability
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Participants
Name Age
(at start)
Diagnosis IQ Communic-ation
Val 14 CP with ataxia
30 Short Phrases
Poor Articulation
Gary 17 MR
Autism
28 Short phrases
Juan 38 MR
Autism
12 10 words
Picture Symbols
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Three-part Approach
AssessmentInterventionMaintenance
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Assessment Phase
DescribeCategorizeVerify
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Describe: InterviewDirect
Observation
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A – B – C
Antecedent-Behavior-Consequence
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Categorize: Identify Function
Identify Context
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Functional Categories
AttentionEscapeTangiblesOther
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Verify:Manipulate
Context (A)Manipulate social
reaction (C)
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Intervention Components
Building Rapport Functional Communication Training (FCT) Building Tolerance for Delay of
Reinforcement Providing Choices Embedding
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Build Rapport Increase positive social interactions.
Provide reinforcers.
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FCT: Teach functionally
equivalent communication.
Address all functions. Teach in all contexts
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Crisis Management
Ignore Momentary restraint Protect Remove Introduce cues
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Building tolerance for delay of reinforcement:
Acknowledge request. Specify contingency. Prompt performance. Prompt communication. Reinforce.
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Providing Choices:
When request can’t be honored.
Activity Choices. Reinforcer choices.
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Embedding: Intersperse SD for problem behavior with SD’s for socially appropriate behavior.
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Generalization: PeopleSettingsTasks
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Mean Frequencies of Spontaneous Communication
Participant Baseline Intervention Maintenance
Val 23 61.8 45.4
Gary 9.3 54.1 25.1
Juan 7.6 52.5 59.2
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Mean Frequencies of Problem Behavior
Participant Baseline Intervention Maintenance
Val 243 3.4 1.0
Gary 77.4 5.5 6.4
Juan 110 9.5 1.7
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Mean Percentage of Task Engagement
Participant Baseline Intervention Maintenance
Val 6% 41% 69%
Gary 36% 54% 70%
Juan 25% 35% 39%
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Social Validity
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Future Directions
Assessment PracticesIntervention PracticesOutcomes