Positive Behavior Support:Changes That Last

Jane I. Carlson, PhD, BCBA

Autism Center of Virginia

Virginia Commonwealth University

Historical Perspective

Internal Validity Experimental Control Statements of

Causation

New Perspective

External Validity Lifestyle Change Practical and Relevant Long-term Change

6-year Longitudinal Study

Goals: Demonstrate Effectiveness of PBS

Implementation by Key Stakeholders

Long-term Maintenance of Effects

Criteria for Inclusion

Severe Problem Behavior Excluded from Community Activities Required Physical Restraint or Medical

Attention Some Communicative Ability

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

Three-part Approach

AssessmentInterventionMaintenance

Assessment Phase

DescribeCategorizeVerify

Describe: InterviewDirect

Observation

A – B – C

Antecedent-Behavior-Consequence

Categorize: Identify Function

Identify Context

Functional Categories

AttentionEscapeTangiblesOther

Verify:Manipulate

Context (A)Manipulate social

reaction (C)

Intervention Components

Building Rapport Functional Communication Training (FCT) Building Tolerance for Delay of

Reinforcement Providing Choices Embedding

Build Rapport Increase positive social interactions.

Provide reinforcers.

FCT: Teach functionally

equivalent communication.

Address all functions. Teach in all contexts

Crisis Management

Ignore Momentary restraint Protect Remove Introduce cues

Building tolerance for delay of reinforcement:

Acknowledge request. Specify contingency. Prompt performance. Prompt communication. Reinforce.

Providing Choices:

When request can’t be honored.

Activity Choices. Reinforcer choices.

Embedding: Intersperse SD for problem behavior with SD’s for socially appropriate behavior.

Generalization: PeopleSettingsTasks

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

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

Mean Percentage of Task Engagement

Participant Baseline Intervention Maintenance

Val 6% 41% 69%

Gary 36% 54% 70%

Juan 25% 35% 39%

Social Validity

Future Directions

Assessment PracticesIntervention PracticesOutcomes