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Direct D Supp port Prrofesssionals Partici P ipant’s Workboo ok
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possitiv e supp ports for peopl p le
ACKN A NOW WLED DGEM MEN NT
ACKNOWLEDGEMENT We would like to take this opportunity to express our appreciation for the valuable assistance and time given by all of the participants listed below in the development of the Clinical and Responsiveness Training Manual. Without the collaboration of all involved, this publication would not have been possible. CART Curriculum Development Brainstorm Group Stakeholder
Organization
Carol Blaind
Access Community Services Inc.
Tabitha Loughlin
Access Community Services Inc.
Sandra Scott
Access Community Services Inc.
John Clarke
Centre for Behaviour Health Sciences
Jim Hughes
Centre for Behaviour Health Sciences
Marnie McDermott
Central East Network of Specialized Care
Brenda Quinlan
Community Living Association South Simcoe
Deb Ryan
Community Living Durham North
Bruce Punnett
Kerry's Place Autism Services
Jim Reaume
Lake Ridge Community Support Services
Savana Napolitano
Lake Ridge Community Support Services
Sandie Hoskin
Lake Ridge Community Support Services
Karen Chartier
Lake Ridge Community Support Services
Erica Dutschek
Ontario Shores Centre for Mental Health Sciences
Jodi Ingram
Ontario Shores Centre for Mental Health Sciences
Gerry Fucile
Tri‐County Community Support Services
Margaret Marchen
Tri‐County Community Support Services
Judy Burke‐Burne
Tri‐County Community Support Services
Laurie Buttineau
Waypoint Centre for Mental Health Care
April Herron
Waypoint Centre for Mental Health Care
Linda Maurice
Waypoint Centre for Mental Health Care
Ray Cole
Waypoint Centre for Mental Health Care
Nancy Pilon
Waypoint Centre for Mental Health Care
Nancy Lewis
York Support Services Network
CART Workbook for DSPs: Acknowledgement
CART Training Content Development Team Name
Organization
Lauri Angus
Centre for Behaviour Health Sciences
Melissa Sweet
Centre for Behaviour Health Sciences
Evangelo Boutsis
Centre for Behaviour Health Sciences
Bethany Kopel
Centre for Behaviour Health Sciences
John Kosmopoulos
Centre for Behaviour Health Sciences
Marnie McDermott
Central East Network of Specialized Care
Christie MacDermid
Community Living Durham North
Karen Chartier
Lake Ridge Community Support Services
Tanya Makela
Lake Ridge Community Support Services
Tabitha Loughlin
Lake Ridge Community Support Services
Erica Dutschek
Ontario Shores Centre for Mental Health Sciences
Margaret Marchen
Tri‐County Community Support Services
Judy Burke‐Byrne
Tri‐County Community Support Services
CART Master Trainers Name
Organization
Lauri Angus
Centre for Behaviour Health Sciences
Evangelo Boutsis
Centre for Behaviour Health Sciences
Bethany Kopel
Centre for Behaviour Health Sciences
John Kosmopoulos
Centre for Behaviour Health Sciences
Karen Chartier
Lake Ridge Community Support Services
Tanya Makela
Lake Ridge Community Support Services
Margaret Marchen
Tri‐County Community Support Services
Judy Burke‐Byrne
Tri‐County Community Support Services
CART Workbook for DSPs: Acknowledgement
IN NTRODU UCTIION
INTRODUCTION People identified as having a dual diagnosis (developmental disability, mental health needs and/or challenging behaviours) that require intensive support and provide many challenges to staff, caregivers and the service system. The Community Networks of Specialized Care were established to: coordinate local specialized service system enhance specialized service delivery, and train and build community capacity to support people with a dual diagnosis in their home communities. As a means to build capacity, a request was received from the Ministry of Community and Social Services (MCSS) to develop a training curriculum. This specialized training will provide staff in developmental service agencies an enhanced skill set to support people with a dual diagnosis, complex and/or changing needs, and behavioural challenges.
BACKGROUND The identified training needs for the Clinical and Responsiveness Training were established through; surveys distributed to agencies in Central East Region, discussion groups and feedback surveys from educational events held in Central Region and the Tri Region Alliance Annual Meeting in 2013. The training needs identified through this data collection focused on enhancing the skill set of the staff to better support people with a dual diagnosis, complex and/or changing needs, and challenging behaviour in their living environments. The following additional criteria for the training program were identified: Provide intensive face‐to‐face training Develop a standardized training continuum and standardized training approaches Develop an assessment tool to evaluate skill level of staff Highlight sensitivities (cultural, linguistic, etc.) in working with families/client Support alternate models for learning including mentoring, train the trainer, booster sessions Develop interdisciplinary team skills Create process for mentoring in the workplace for staff Deepen knowledge and skills through ongoing monthly consultation using videoconferencing technology With the above needs and criteria in mind, the Central East Network of Specialized Care, upon receipt of funding for the project, set out a formal statement of goals/objectives for the Clinical and Responsiveness Training (CART) curriculum:
GOALS The goal of the CART training is to enhance the skills and knowledge of staff in the developmental service sector in Central East Region so that the highest quality of support can be provided for adults with a dual diagnosis, complex and/or changing needs, and behavioural challenges in their support environments. The CART curriculum will increase the knowledge, confidence, and understanding of Direct Support Professionals in the use of Positive Behaviour Support, including the use of proactive strategies and creating habilitative environments to decrease and prevent challenging behaviours. CART Workbook for DSPs: Introduction
Specifically, the goal of the training was to ensure that Direct Support Professionals who were trained would be able to: Define complex and/or changing needs and challenging behaviour. Understand the importance of using the Biopsychosocial Model when supporting people with a dual diagnosis. Discuss how the use of Applied Behaviour Analysis integrates the recognition of the Biopsychosocial Model in developing behaviour plans and crisis plans for people with a dual diagnosis. Incorporate the requirements of the Quality Assurance Measures regarding Ontario Regulation 299/10 into the supports provided to people with a dual diagnosis (e.g. Behaviour Support Plans). Create wellness in the workplace using mindfulness based strategies. Understand and be able to access specialized resources to support people with dual diagnosis. Research indicates that learning supported through ongoing coaching/mentoring (via direct supervisors or managers) produces better skill development outcomes. To ensure that the training goals for Direct Support Professionals were met, ongoing support in translating their learning to on‐the‐job behaviours would be required. As a result, the CART training for Managers/Supervisors that was developed focused on teaching and practicing coaching skills.
TRAINING OUTCOMES Standardized Curriculum Developed: Standardized clinical and responsiveness training model (CART) focused on building positive support approaches, behaviour and clinical plans is developed, along with manuals and training materials Front‐Line Staff and Managers/Supervisors Trained: Clinical and Responsiveness Training (CART) was delivered to 125 participants (Front‐Line Staff & Managers/ Supervisors) in Year 1 and 150 participants in Year 2 Skills and Confidence Enhanced: Front‐Line staff and Managers/Supervisors have enhanced skills and confidence in their roles (as evaluated through an assessment tool) Knowledge Exchanged: Participants’ learning is shared through mentoring or peer training and Videoconferencing peer consultation to further build capacity A common clinical assessment and intervention language is shared so that it can be applied across sectors Inter‐disciplinary team skills are developed Professional partnerships (at the staff training and delivery levels) are built between Ministry of Community and Social Services funded agencies
CART Workbook for DSPs: Introduction
Directt Support Profe essionals: Worrkbook C Conten nts Po ositive Sup pports for People: A A Foundatio on for CAR RT Trainin ng
The Mod dules Module
Knowledge e/Skill Areaas
1
Positive Behaviour Supports
1. 2. 3.
Und derstanding Yo our Role in thee Big Picture Thee Discovery Pro ocess Selff‐Assessment and Reflection n
2
Understand ding Behaviou ur
1. 2. 3.
Deffining Behavio our Beliefs about Beh haviour haviour in Con ntext Beh
3
Proactive In nterventions
1. 2. 3.
Und derstanding Se etting Event an nd Anteceden t Intervention ns Com mmunication Cho oice Making
4
Changing C Consequences
1. 2.
Ideentifying and U Understanding Consequencees Chaanging Conseq quences, Changing Behaviouur
5
Functions o of Behaviour
1. Ideentifying Functions of Behaviiour 2. Conntributing to aa Functional Beehaviour Assesssment
6
Teaching Skkills
1. 2. 3.
Cho oosing Skills to o Teach Buiilding a Skill Te eaching Plan Using Skill Teachiing Strategies
7
Collaborating to Addresss Challengingg Behaviours
1. 2. 3. 4.
Maaking the Link Collaborating and d Contributingg to Behaviour r Support Plan plementing an nd Problem Sollving Behaviouur Support Plans Imp Deb briefing
Go Forward P Planning Resourcces Key Persson My Develop pment
CARTT Workbook fo or DSPs
What we know is that people with difficult behaviours are often missing:
Here’s where the Direct Support Professional and the Coach role can really make a difference. Collaborating to make a difference is the way to go because: • • • •
CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
Page 1
MY DEVELOPMENT
KEY PERSON
•
No‐one can ‘go it alone’ Each of us needs support, feedback Each of us needs knowledge and skills and can learn from each other We need to collaborate to understand different perspectives, see things differently sometimes, and from a different angle We need to ask for and get help when things get complicated and when we can’t see clearly
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
Meaningful relationships A sense of safety and well‐being Power Things to look forward to A sense of value and self‐worth Relevant skills and knowledge Supporters who are themselves supported
GO FORWARD PLANNING
• • • • • • •
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
The person’s story—biological, psychological, social Your observation—what you see and hear The Person Directed Plan The impact of environment The person’s skill level What happens when a person can’t communicate needs The behaviours that interfere with relationships and participation
RESOURCES
• • • • • • •
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
In this training, we will focus on seeing ‘behaviour’ through a different lens, one that is designed from the Positive Behaviour Support approach. We will work to see the connections between your Focus Individual, you, your Coach, and the environment. We will do this by highlighting the importance and understanding of:
UNDERSTANDING BEHAVIOUR
➠ Making the Connections About Positive Supports for People
PROACTIVE NTERVENTIONS
Positive Supports for People | A Foundation
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Th his training is based on tthe belief thaat providing g positive su upport has aa foundation n in Perrson Directeed Planning. This means making a commitmen nt to using aa Person Direected Pla anning apprroach with eeveryone in tthe supportt environmen nt. Taken brroadly, the ssupport env vironment includes the people you u support, otther staff, yo ou as a Direcct Support h’ as we willl think Pro ofessional, y your team‐m mates, and your Manageers/Supervissor or ‘Coach of tthem in thiss training. Support Pro ofessionals w will encourage the learn ning of skillss, and will co onsider Jusst as Direct S thee role of the support env vironment, C Coaches neeed to encourrage Direct SSupport Pro ofessional to o: • Learn new w skills g the enviro onment when there are cconcerns thaat interfere w with • Contributee to adapting their capaccity to suppo ort people Positive suppo ort practice iincludes a commitmentt to inclusion n, communiity participaation, oice, and qu uality of life enhancemen nt. We enco ourage you tto make the commitmen nt and cho ironment th to b be prepared d to challeng ge practices within the ssupport env hat are incon nsistent witth this approach.
➠ The Cllinical And Respponsivenness Training Cooaching Ap pproach h Th he CART traiining will fo ocus on teach hing coachin ng skills tha at fall within n the strateg gies of Mo odel, Support, and Facillitate.
Model: The C M Coach is a peerson who models aand lives by the vaalues of Positive Behaviour Su upport. Su upport: The Coach is a p person who supportss others by ggiving feeedback and d maintaining po ositive relationships. Faacilitate: Th he Coach is aa peerson who facilitates po ositive ch hange, learn ning and growth.
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
➠ Positivve Suppoort and PPerson Directed D d Plannin ng
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CART Workkbook for DSPss: Positive Sup pports for People – A Founddation for CAR RT Training
CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
Page 3
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
We will work through the elements of the CART Framework, consider the key Direct Support Professional and Coach’s role, give you an opportunity to learn about each element, and practice the skills involved. This will allow you to contribute fully to creating a positive, meaningful support environment.
The CART Framework
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
There are a number of tools and processes available to guide our work and these make up the CART Framework, which is based on the Positive Behaviour Support approach. It’s all about positive supports for people.
UNDERSTANDING BEHAVIOUR
Positive Behaviour Support enhances quality of life by building skills, preventing problems and altering environment to minimize challenging behaviours and maximize participation and satisfaction.
PROACTIVE NTERVENTIONS
By taking a Positive Behaviour Support approach we will understand others better. If we take into account what the person is all about, we can support them better, and we can increase and help support positive behaviours and decrease challenging behaviours.
CHANGING CONSEQUENCES
Why Take a Positive Behaviour Support Approach?
FUNCTIONS OF BEHAVIOUR
➠
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR
This is the underpinning of all aspects of support, assessment, planning and intervention.
Person Directed Plan
A plan to understand the person’s interests, goals, preferences, and to guide choices and support independence.
Support Plan
A plan to identify: The activities and support people that are in place to make sure the person’s goals are translated into action Who is responsible for what activities and roles, and when these things will happen Proactive and prevention approaches to promote community participation and quality of life
Biopsychosocial Formulation
A ‘work in progress’ document to understand the whole person, looking at underlying issues and what may be contributing to a problem. When behaviours are of concern, the process uses discovery questions to understand what the behaviour is communicating and leads supporters to take action or investigate further.
Functional Behaviour Assessment
Functional Behaviour Assessment uses direct and indirect methods to collect information about the function of behaviour—what need the behaviour is meeting and what it is communicating—and points to relevant interventions. The Direct Support Professional would contribute to the Functional Behaviour Assessment and would always be collaborating with a Behaviour Consultant.
Behaviour Support Plan
A plan is to make sure staff and the person are using a consistent approach to support the person in the most positive and least restrictive ways (to prevent ‘problem’ behaviour, be proactive, support quality of life, participation, and relationships). The plan will also include interventions to be used consistently when challenging behaviours occur.
Integrated Clinical Plan
This is a plan for the most complex situations when: Many disciplines are involved We need to understand how all the pieces fit together We have to collaborate to develop, implement, and monitor the response or intervention plan A more specialized response is needed
FUNCTIONS OF BEHAVIOUR TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS KEY PERSON
RESOURCES
GO FORWARD PLANNING MY DEVELOPMENT
What is it?
Understanding the person – their wants, needs, and goals
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
Tool / Process
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CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
FOUNDATION UNDERSTANDING BEHAVIOUR
The Person Directed Plan is the domain of the Direct Support Professional, and likely a core part of your function already. This is at the foundation of everything that follows. A positive support culture promotes the person directed values of respecting people, rights, dignity, and choice. We can do this by:
“…the best time to intervene with problem behaviours is when they are not occurring,” (Carr et al., 1994, pp. 15) Dr. Edward Gary Carr (b. August 20, 1948, Toronto, Canada ‐ d. June 20, 2009, Wading River, New York) was an internationally‐recognized pioneer in autism treatment research. Dr. Carr applied studies about the functions that self‐ injurious behaviours served and contributed substantially to the development and refinement of “Positive Behaviour Support” (Carr et al., 2002)
RESOURCES
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
WORDS OF WISDOM
CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
Page 5
MY DEVELOPMENT
KEY PERSON
FUNCTIONS OF BEHAVIOUR
Because difficult behaviours may result from unmet needs, when we focus on understanding and meeting needs first, we may discover that difficult behaviours can be avoided. We can then identify other issues, but the whole picture will be clearer.
TEACHING SKILLS
By maintaining a focus on the person’s Person Directed Plan we will promote the values of discovery, individuality, choice, rights, inclusion, and quality of life. Each organization will have its own approach. The important thing is to make it specific to, meaningful for, and owned by the person.
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
•
Maintaining daily interactions with others Building rapport and relationships Listening…attentively and fully Supporting the individual in ways that are consistent with their preferences, interests, and needs Keeping promises
GO FORWARD PLANNING
• • • •
POSITIVE BEHAVIOUR SUPPORTS
➠ The Person Directed Plan
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
➠ Questions to Ask When Building a Positive Support Plan
UNDERSTANDING BEHAVIOUR
John and Connie Lyle O’Brien (2003) suggest the following questions for building a support plan. Notice how different these questions are from those we typically ask, such as “How can we reduce this person’s problem behaviours?” or “How can we manage this behaviour?”
PROACTIVE NTERVENTIONS
• • •
CHANGING CONSEQUENCES
• • • •
FUNCTIONS OF BEHAVIOUR
These are questions that are important to each of us as we seek meaning and authentic connection in our lives.
➠ What is Positive Behaviour Support?
TEACHING SKILLS
Positive Behaviour Support is everything that you do as a Direct Support Professional to support a good fit between what the person needs, what the environment around them has to offer, and the skills they need to live and be successful in that environment.
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Positive Behaviour Support practice includes continually thinking about the person’s Person Directed Plan so that you include appropriate activities, respect their preferences, and respect what is important to them about relationships, place, space, routine, and being heard. It means taking your time to listen to them. People have needs; they communicate their needs in their own unique way. If they are distressed they may not have the words—but you can still listen and observe. Positive Behaviour Support is also about building skills that the person needs for independence, such as making choices and communicating. Some generic skills may lead to frustration if the person does not possess these skills — for example, stress management skills, social skills, functional skills, and communication skills. In addition, Positive Behaviour Support is about understanding and altering environments (understood broadly) to enhance quality of life and prevent challenging behaviours.
KEY PERSON
RESOURCES
GO FORWARD PLANNING MY DEVELOPMENT
How can we help the person to expand and deepen his/her relationships? How can we help the person to achieve a sense of health and well‐being? How can we help the person to have more fun in ordinary, everyday community places? How can we help the person to have more power? How can we help the person to make a contribution to others? How can we help the person learn valued skills? How can we help the person supporters to get the support they need?
A Positive Behaviour Support approach includes thinking differently about how to support a person who is emotionally distressed. When we think and react differently, we can help to prevent more serious challenges for the person.
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CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
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FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR MY DEVELOPMENT
KEY PERSON
3. Teaching Alternative Skills Teaching effective, alternative skills to prevent or replace problem behaviours; teaching adaptive skills that enhance independence with a goal to creating long‐ lasting change.
RESOURCES
2. Creating Supportive Environments and Changing Problem Environments Designing interventions that are matched to the hypotheses about why the problem behaviour is occurring and tailored to the person’s unique social, environmental and cultural setting. Adapting environments based on a person’s needs and preferences can prevent behaviour problems.
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
1. Functional Assessment Understanding the reasons for (or the “function” of) problem behaviours by asking what environmental events or conditions are provoking and supporting the behaviours. (This is done by developing and testing hypotheses through data collection. Although the Direct Support Professional and Coach can begin gathering data and information, the Behaviour Consultant will need to come in here).
The PBS process has three cornerstones:
CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
PROACTIVE NTERVENTIONS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Positive Behaviour Support strategies and interventions are considered effective when they: Result in increasing a person’s success and personal satisfaction Enhance positive social interactions across work, academic, recreational, and community settings Increase quality of life as defined by a person’s unique preferences and needs Lead to positive lifestyle changes that increase social belonging
CHANGING CONSEQUENCES
People generally do not want to behave in a disruptive way, and if they are given strategies and skills designed for their unique needs, they won’t behave disruptively. This means, going beyond the ‘quick fix’ to really entering into their experience. Positive Behaviour Support is essentially putting ‘feet’ on the Person Directed Plan. The goals of Positive Behaviour Support are to increase quality of life and decrease problem behaviour. It is about supporting people to: Enjoy life Develop positive relationships with others Be as independent as possible Live a normal life Develop a sense of personal agency through experiencing sufficient choice and control in their life Improve competence in managing their daily life Be recognized for positive contributions Overcome problem behaviour
FOUNDATION
WORDS OF WISDOM
“I have found that I most enjoy my work and am most helpful to others when I let them affect me….if I can hear another person’s words, not from a place of clinical distance, but as they touch me and resonate inside me, then I can bring a fully alive, human presence to bear on the other’s experience, which is much more likely to create an environment in which healing can occur.…authentic presence is sparked in therapists when they let themselves be touched by the client, when they can really feel what it is like to be in the client’s world so they can respond from a place of true empathy and compassion.” Source: John Welwood (1983). Awakening the Heart: East/West Approaches to Psychotherapy and the Healing Relationship. Shambhala
FUNCTIONS OF BEHAVIOUR
Every day, reactive strategies are used to respond to many different kinds of problems that are encountered. Environmental crises resulting in deaths and disabilities often occur before possible solutions for cleaning up local contamination are considered. Prison systems are based upon our reaction to societal crimes. Meanwhile, the social problems that give rise to these crimes are not addressed. Schools commonly rely upon punishment and exclusionary practices to address student misbehaviour. Individualized Behaviour Support Plans are often implemented in response to the occurrence of problem behaviours. Positive Behaviour Support emphasizes prevention and proactive strategies. This is the domain of the Direct Support Professional. Proactive and prevention strategies include:
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
➠ Positive Behaviour Support Interventions
TEACHING SKILLS
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
Positive Behaviour Support is not just about changing a behaviour, it’s about changing how we communicate, how we set up routines and activities, how we offer and support choice making, and how we help people learn skills to engage and participate in meaningful activities in their community. Teaching social skills and designing predictable and positive environments can decrease the need for reactive strategies.
Proactive and Prevention Strategies
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Skill teaching Environmental adaptations Activity modifications Lifestyle enhancements Prompting Increasing choice Positive reinforcement
CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES
CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
Page 9
GO FORWARD PLANNING
These interventions are about altering the social, physical and structure/routines in the environment based on taking into account individual preferences, sensitivities, wants and needs. Environmental adaptations include: • Choice making protocol • Activity sampling • Building positive rapport • Community access • Lifestyle enhancements • Access to food and drink • Prompting • Access to relaxation • Establishing or altering routines • Pictorial activity schedule • Strategies for managing transitions • Adaptations to activity (schedule, • Physical environment modifications duration, type)
RESOURCES
Environmental Adaptations
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
Community/adaptive living Leisure skills Emotional regulation skills Replacement skills
KEY PERSON
• • • •
MY DEVELOPMENT
Skill teaching is typically focused on: • Relaxation skills • Conversation/social skills • Self‐help/adaptive/functional skills • Communication/self‐expression skills
FUNCTIONS OF BEHAVIOUR
Skill Teaching
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS KEY PERSON
RESOURCES
GO FORWARD PLANNING MY DEVELOPMENT
Direct Individualized Interventions Direct interventions can reinforce the prosocial (positive and desirable) behaviours that the person will benefit from doing more often. This strategy is readily available to the Direct Support Professional. A simple, genuine statement of praise or thanks for a specific action or behaviour is what we do for each other all the time.
Direct interventions include: • Differential reinforcement of positive behaviour • Differential reinforcement of low rates of concerning behaviour • Differential reinforcement of alternative behaviours
Reactive Strategies Reactive strategies include how you respond as a Direct Support Professional to any behaviour. Usually, this is with the intention of supporting and increasing positive behaviours that will ensure the person’s needs are met. You can use non‐intrusive reactive strategies when you see something brewing, like the early signs of distress.
Reactive strategies include: • Active listening • Feedback • Redirection • Limit setting
• • • •
Adapted communication Facilitated relaxation or self‐soothing Facilitated problem solving Distraction
We may become too focused on the more formal nonviolent crisis intervention or safe management approaches that all Direct Support Professionals have been trained in. Yes, we need to think about how we respond when behaviours are more challenging, but we can also use reactive strategies to prevent escalation and to respond effectively and personably to the person in the moment when we see the first signs of escalation. It is important that we don’t think that at the first signs of agitation, we need to jump into planned de‐escalation strategies. Active listening or redirection can be very effective. Sometimes a person needs assistance to communicate, to use self‐soothing strategies or self‐management coping skills, needs redirection, or needs understanding and help to address a concern, just as each of us does. Listening to, and acknowledging, emotions can be hugely effective. We all need to be understood.
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CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
Moving Forward with Discovery When understanding and support are not enough When behaviours persist When underlying medical, psychological, and social causes have been investigated and addressed, and behaviour persists
............. use a positive behaviour approach including building skills and adapting environment
....................... use the Biopsychosocial approach to assist in identifying areas to explore and potential responses
CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES KEY PERSON
..................... use a functional assessment to understand ................ the purpose that the behaviour is serving
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Now, taking it to the next step, you have done your work as Direct Support Professional, your managers and supervisors support all the interventions we have talked about, but despite all your efforts, concerning behaviours persist.
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•
Direct Support Professionals act as ‘eyes and ears’ and lead the discovery Person Directed practice permeates all aspects of a positive behaviour approach Each of us comes with unique knowledge and skills, as well as attitudes and beliefs Relationships are at the core of this approach Behaviours communicate in spades and need to be understood Use Positive Behaviour Support strategies to understand and address behaviour concerns For some people you will have to move to “discovery mode”
MY DEVELOPMENT
• • • • • •
FUNCTIONS OF BEHAVIOUR
So far what we have learned about Positive Behaviour Support is that:
TEACHING SKILLS
➠ The Discovery Process
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
In Module 3 you will learn the importance of strategies to intervene around antecedents. This will include understanding all the components of environment (and there are many) as well as interventions to adapt the environment.
GO FORWARD PLANNING
Now, we move on to how we think about the person’s environment, our role in that environment, and the impact of environment on the person. The idea of devoting time and energy to create an environment that reduces problem behaviour is sometimes met with resistance. It is important to understand that placing an emphasis on prevention will set the stage for fewer crises in the future.
RESOURCES
➠ About the Environment
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
While Positive Behaviour Support cannot ‘cure’ underlying biological bases for mental illnesses, it has been shown that it can reduce the behaviours of concern for those who have mental health or physical health conditions. So, the discovery process continues.
UNDERSTANDING BEHAVIOUR
Let’s keep in mind that although people may have positive and respectful social and physical environments, there may be pervasive or deeper issues. If someone has physical pain, then all the positive support and care in the world will not resolve that issue.
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
Assessment and clinical investigation can be very important. The Direct Support Professional’s role in asking questions, and being key to the investigation, drives this. A significant number of people engage in problem behaviours that are not linked to social or environmental functions. When a team is unable to identify clear signs that environmental variables are influencing problem behaviour, it is possible that biological factors may play a part in the occurrence of problem behaviour. Direct Support Professionals need to understand:
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
• • • •
The ways in which biologically‐based issues affect behaviour The difficulties involved in the diagnosis of mental illness in people with developmental disabilities Issues related to, and side effects of, psychotropic medications When it’s important to consult with a Health Professional, Allied Health Professional, or Behaviour Consultant
➠
Predisposing and Underlying Factors – Health Issues
When we talk about a “behaviour of concern,” we will think of these as consistent behaviours that interfere with support, relationships, and participation. There are many areas for you to consider including: • • •
Medical issues Mental health issues, diagnoses, and psychological needs Social, family, and peer issues
It’s time to go deeper. There are a number of common medical or health issues for people with developmental disabilities that can often go undetected, as well as common medical or health issues associated with problem behaviour. These are underlying issues that impact behaviour and wellbeing. Understanding them will help us use a broader lens when assessing the person.
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Environment, interpersonal, programmatic, physical
Each area, however, cannot be treated independently, as there are several influencing factors that are considered dynamic and interactive. These influencing factors include: • Historical: What is there in the person’s background in each of the B P and S areas that contributes to the current situation? • Contributing/Sustaining Factors: Why are issues present now? What are the triggers, what’s new, and what’s keeping the issue or problem going? • Strengths: What are the positive features of the person and/or the strengths of those around them (internal and external resources) that can be enlisted to address the problem or issue? CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
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FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR GO FORWARD PLANNING
SOCIAL
RESOURCES
Current psychological features and skill deficits
(logical)
KEY PERSON
PSYCHO
MY DEVELOPMENT
(medical)
Medical, psychiatric, medication reactions, syndromes, neurological state
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
The Biopsychosocial approach involves three domains:
BIO
PROACTIVE NTERVENTIONS TEACHING SKILLS
➠ The Biopsychosocial Approach
CHANGING CONSEQUENCES
So if we are really interested and committed to understanding the person in a holistic way we need to go deeper. Think about this as a discovery process. The Direct Support Professional needs to be a sleuth, to pull together what the person is all about including some of the underlying issues that may be hidden from view (e.g. psychotic illness, earache, toothache, stomach issues, trauma issues, urinary tract infection, etc.).
FUNCTIONS OF BEHAVIOUR
Statistics related to persons with developmental disabilities highlight the need to investigate medical and psychological issues: • 43% have undiagnosed health problems (simple things like high blood pressure, gastro and colitis) compared to 8.3% of the general population • 25% do not have their dental needs attended to (and if they are identified as having dental difficulties, many receive inadequate or inappropriate care) and suffer because of dental pain. • Children with disabilities are 5 times more likely to be abused than the general population • One third of women with intellectual disabilities report being victims of sexual abuse • In Canada, one baby with Fetal Alcohol Syndrome is born every day • Even though only 38% have mental health needs, half of the adults with developmental disabilities are prescribed psychotropic medication with NO diagnosable psychiatric disorder. Medication is used to control challenging behaviour when there is little evidence that it is effective. Side effects and interactions have significant impact on behaviour due to response sensitivities.
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
➠The Biopsychosocial Formulation
One example of how to document the formulation process is the Biopsychosocial Formulation Grid.
Biopsychosocial Formulation Grid
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
The Biopsychosocial formulation that takes into consideration all three Biopsychosocial elements, is not built on assumptions or hunches, but must be supported with factual data and observations. It needs to relate back to specific experiences or information provided by the person or others involved with them in the past and present. It is a work in progress and will change and develop as changes take place in any domain.
FUNCTIONS OF BEHAVIOUR
Historical Factors • Predisposing Contributing & Sustaining Factors • Precipitating • Perpetuating Strengths & Resources Protective
TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Psychological Emotional Cognitive Behaviour
Social Formal & Informal Supports Family
Direct Support Professionals have an important role in the discovery process and can use the grid as a tool to increase understanding and guide action. To do this, a Direct Support Professional needs to look at the areas within the Biopsychosocial domains where information can be found.
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
Biological Medical Genetic Medications
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FOUNDATION
The ‘Over to U’ tool is a good resource and includes questions which can be explored in each domain to assist in the formulation process.
➠ Some Tips for Understanding the Bio of Biopsychosocial It’s worth taking the time to collect and read thoroughly through a person’s history to understand what you may have missed. Sometimes important medical and psychiatric information gets lost in the course of moves and shifting priorities. Questions to determine predisposing elements: • What might be causing physical discomfort? • Are the person’s basic needs being met? • Any noticeable change in eating, sleeping, physical routine/elimination, self‐care? Any pattern, how long, time of day? • Any observable change to energy level, overall mood, facial/communication/ behavioural expression? • Is there a history of a recurring medical/dental condition (digestive, ear, urinary, heart, respiratory, abscess)? • Does the person have any syndromes/predisposing genetic conditions/ neurological issues? • Are there any sensory limitations, sensitivities, vulnerabilities, or disabilities (hearing, vision, sensitivity to touch, noise)? Any restrictions in movement, unusual movements? • Have there been recent medical and dental exams? Any issues, treatment in progress? • Has the person been assessed for mental health issues? Any medications? Any side effects? What psychiatric diagnoses? What do I need to know about how symptoms are expressed for this person? What do I know about developmental milestones (physical, sexual, learning)? CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
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Early childhood experiences, school, family, and social experiences in the distant past
PROACTIVE NTERVENTIONS
SOCIAL
CHANGING CONSEQUENCES
(logical)
Specifics related to any history of trauma/abuse, significant separations
FUNCTIONS OF BEHAVIOUR
PSYCHO
TEACHING SKILLS
(medical)
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Specifics related to medical and psychiatric history or diagnoses
GO FORWARD PLANNING
BIO
RESOURCES
Examples of Historical Factors
KEY PERSON
DOMAIN
MY DEVELOPMENT
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
For instance, when thinking about predisposing or historical factors, the grid would look like this:
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR TEACHING SKILLS
Your organization should have on file any psychiatric assessment or psychological assessments completed. If not, it will be useful to request them particularly if there are complex needs emerging. Even if the assessments are old, such as social histories from child treatment centres and child welfare care, they often offer a picture of some of the trauma and attachment issues a person may have survived. Earlier multiple diagnoses of Attention Deficit Hyperactivity Disorder (ADHD), conduct disorder and/or depression can sometimes indicate the early signs of other mental disorders (e.g. bi‐ polar disorder). It is also important to identify whether there are Fetal Alcohol Effects, as support approaches may need to be different with these people. Where there is a list of previous diagnoses and current psychiatric assessment is not available on file, it is always worth discussing this with the primary care practitioner as they may not have historical information available. If family members are not ‘on the scene’ to provide history, the Direct Support Professional role is particularly valuable.
Trauma People now living in the community may have been in institutions, incarcerated, or in foster homes (where they may not have been treated either safely or respectfully). This is highly significant information as there may be reverberations of trauma that relate to behaviour. Also, sensitivities because of previous abuse need to be considered.
Neurological A high proportion of people with developmental disabilities have been diagnosed with epilepsy at one time or another, or other neurological abnormalities (even Acquired Brain Syndrome from birth trauma) and this information may not follow them along. It will impact their behaviour as well as assist in thinking about how best to intervene when there are behaviour changes.
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Syndromes Although low ‘incident’, many syndromes can be associated with increased challenging behaviour, such as Lesch‐Nyan, Fragile X, Williams syndrome, Rhombencephalosynapsys, Cornelia de Lang and Rett Syndrome. It’s important to know and understand these syndromes. You need to take the lead and actively seek out more information.
Health Conditions There are a number of health conditions that can cause challenging behaviour which can present what seem like sudden symptoms, which may be expressed through behaviour change: • Hypo/hyperglycemic episodes in diabetes • Urinary tract infections • Uncontrolled pain (that limited expressive language requires behaviour to communicate) • Dementia • Hypothyroidism (especially in Down’s syndrome) • Constipation • Hormonal imbalance (including PMS in females and raised testosterone in males) Page 16
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➠
Making the Links Between Positive Behaviour Supports, Biopsychosocial, and Functional Behaviour Assessment •
•
•
•
The Biopsychosocial approach helps us understand all areas of functioning, using a wide lens to discover and understand, so that predisposing issues and their impact are understood and responded to. The overlap with Positive Behaviour Support is related to what is going on with the person beneath the surface, which may or may not be related to the environment. The Biopsychosocial approach is important when building skills and altering the environment have not changed behaviour and more investigation needs to be done. Where there are no predisposing factors that can be addressed, or when they are addressed and the problem continues, it will be useful to complete a Functional Behaviour Assessment. The first step is learning the ABCs.
CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
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UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS MY DEVELOPMENT
KEY PERSON
RESOURCES
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Discovery and understanding Appreciative inquiry—learning to ask questions of the person and their caregivers Engaging who you need to help sort it out Paying attention Getting a rich picture of the person’s experience and situation
• • • • •
CHANGING CONSEQUENCES
This process is all about:
FUNCTIONS OF BEHAVIOUR
• •
Identify questions and things you need to find out Sort out the next steps Understand if there are behaviours that may actually be associated with health and mental health issues Broaden your lens on the person Step into their shoes
TEACHING SKILLS
• • •
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Doing a Biopsychosocial formulation brings about deeper understanding by helping you to:
GO FORWARD PLANNING
➠Why Complete a Biopsychosocial Formulation?
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS
Antecedents—events that take place before behaviour occurs to make it more likely that desirable behaviour will occur and problem behaviour will not. Every behaviour has an antecedent.
Behaviour—what we see, observe, hear and can measure in how a person acts.
Consequences—events that take place after behaviour occurs. Every behaviour has a consequence.
Example of what precedes and follows aggressive behaviour:
TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS KEY PERSON
RESOURCES
GO FORWARD PLANNING MY DEVELOPMENT
Understanding the ABCs
ABC is a way of thinking about human behaviour. We will spend more time on this in Modules 2, 3 and 4. We want you to think about behaviour in relation to what comes before it and what comes after it. We will challenge you to look at your own behaviour as well as the behaviour of those you support.
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
➠
Antecedent
Behaviour
Consequence
Laughter of others in the room
Bill hits peer on arm; Bill kicks over / breaks shelf
Staff attend to Bill exclusively to calm him
➠ Functional Behaviour Assessment The Functional Behaviour Assessment is done when challenging behaviours persist. You may have done some thinking and observing of the ABCs and some initial data collection. It is now time to call in the behavioural experts, as it is critical to accurately determine the function of a behaviour in order to build a plan to address that specific behaviour. It’s important to get the function right, not to use guesswork or work from assumptions. What may look like ‘attention seeking’ may in fact be a way of getting out of performing a skill that the individual does not have competence in and very different interventions would be needed. We’ll explore this further in Module 5. The Direct Support Professional needs to observe, measure, and document behaviour in order to contribute to the Functional Behaviour Assessment. This assessment cannot be completed without input from Direct Support Professionals as the ‘eyes and ears’ ‐ they know the person best and are present in their day‐to‐day environment.
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• •
CART Workbook for DSPs: Positive Supports for People – A Foundation for CART Training
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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MY DEVELOPMENT
KEY PERSON
RESOURCES
•
Take time for yourself during the work day. Take your allotted breaks and make the best of them. Get outside for some fresh air, stretch and take deep breaths all the way into your belly or just sit and relax with your eyes closed for a few minutes. Treat your body well. Get enough sleep and eat healthy. It’s challenging work that you do. You need to be rested and healthy. Talk about your stressors with your peers and your supervisor. You are not invincible, and it is so important to process your experiences with others in the same field. Be willing to be honest about how you feel. Find quick self‐care rituals to fit into your busy day. Think of simple ways to make time for yourself. Can you take mini breaks? A ritual at lunch where you listen to 10 minutes of your favourite music? A walk to the corner and back? A few yoga postures? What would work for you?
TEACHING SKILLS
•
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
You are the eyes, ears, and heart of support for the people you serve. It is important to make sure you are healthy, available, present and resilient through the ups and downs of a day. The message is: Take care of yourself!
GO FORWARD PLANNING
➠ Resiliency
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
Direct Support Professionals will make valuable contributions to development and implementation of a practical and effective Behaviour Support Plan. They will be the on‐the‐ ground resources that will make or break the success of every Behaviour Support Plan. Only the Direct Support Professional can monitor change or observe that behaviour concerns persist.
UNDERSTANDING BEHAVIOUR
Completing a Functional Behaviour Assessment may or may not lead to development of a Behaviour Support Plan. The regulations of the Social Inclusion Act direct developmental service providers to complete a Behaviour Support Plan for any individual who has challenging behaviour, and in particular for those who may require ‘intrusive measures’, even if only as a last resort. Intrusive measures will only be implemented when the full range of less intrusive interventions has been tried.
PROACTIVE NTERVENTIONS
➠ Behaviour Support Plan
FOUNDATION UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
Ass effectivve and rresilient supportters we can
Build skkills to help increase and support positive behaviours
Take into aaccount what the pe erson is about ass we support tthem
A Alter environ nments to maximize / d ecrease challenging behaviou urs
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
Un nderstand Better
Enhaance the quality o f life, for the person, their peers, and theeir support sstaff
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Alter environmentts o maximize to partiicipation and saatisfaction
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CART Workbook for Direct Support Professionals: Slides & Exercises
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for Direct Support Professionals: Slides & Exercises
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for Direct Support Professionals: Slides & Exercises
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for Direct Support Professionals: Slides & Exercises
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for Direct Support Professionals: Slides & Exercises
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for Direct Support Professionals: Slides & Exercises
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for Direct Support Professionals: Slides & Exercises
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for Direct Support Professionals: Slides & Exercises
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for Direct Support Professionals: Slides & Exercises
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for Direct Support Professionals: Slides & Exercises
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for Direct Support Professionals: Slides & Exercises
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for Direct Support Professionals: Slides & Exercises
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for Direct Support Professionals: Slides & Exercises
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR
Principles: The Person Directed Planning approach and the positive support practices that integrate this approach are the foundations for building and implementing respectful support and effective intervention approaches. Enhancing the quality of life and community inclusion of the people supported is the primary purpose of all Direct Support Professional and Coach activity. Learning Direct Support Professionals will be able to: Outcomes: Describe the relationship between Person Directed Planning and Positive Behaviour Support approaches
Knowledge/ Skill Areas
Communicate the role of assessment and planning processes, and tools used
Identify own role and contribution in the support environment
Understand the Biopsychosocial approach and the role of ‘discovery’ in understanding the person
Describe the environmental variables that impact behaviour
Understand how Direct Support Professional behaviour and attitudes impact people and the support environment
Identify self‐care strategies; articulate the value of self‐reflection in Direct Support Professional role
1. Understanding Your Role in the Big Picture 2. The Discovery Process 3. Self‐Assessment and Reflection
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
MODULE 1 | Positive Behaviour Supports
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
A. Think abou ut and comp plete the diaagram, inse erting one th hing that is vvery importtant to you in e each of the d domains:
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
Ex xercise: What W Ma atters
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CART Workbook forr DSPs: Modulle 1‐ Positive B Behaviour Sup pport
FOUNDATION
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MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
B. Think about you ur Focus Perrson and com mplete the diagram insserting ONEE thing that is very important to them in e each of the domains (iff you don’t kknow, don’tt guess!):
POSITIVE BEHAVIOUR SUPPORTS
Exerciise: Wha at Matterrs
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
Exercise: What Matters to your Focus Person
Areas in common:
Areas that I don’t know about:
Things I want to explore:
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CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS GO FORWARD PLANNING
My Focus Individual’s strengths: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ What I find most challenging in supporting my Focus Individual: __________________________________________________________________________
MY DEVELOPMENT
KEY PERSON
RESOURCES
__________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Reesiliency Tip
GO FORWARD PLANNING
Talk ab bout your sstressors w with your peeers and yoour supervvisor. You aare not invincible, and d it is so impportant to ‘pro ocess’ your experience es with others who woork in the same ffield. Be willing to be honest abo out how yo u are feelingg.
MY DEVELOPMENT
KEY PERSON
RESOURCES
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CART Workbo ook for DSPs: Module 1‐ Possitive Behavio our Support
Least Preferred Item:
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
Environmental Change:
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COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
GO FORWARD PLANNING
RESOURCES
KEY PERSON
MY DEVELOPMENT
FUNCTIONS OF BEHAVIOUR
Preferred Item: CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
Questions:
Need to Know:
Page 39
TEACHING SKILLS
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Actions:
GO FORWARD PLANNING
RESOURCES
FUNCTIONS OF BEHAVIOUR
KEY PERSON
DOMAIN:
MY DEVELOPMENT
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
Exercise: Biopsychosocial Discovery Thinking about your Focus Individual, what do you know and what do you need to know more about related to the ‘bio’ of Biopsychosocial? Historical: What has led up to this problem?
MY DEVELOPMENT
KEY PERSON
RESOURCES
Contributing and Sustaining: Why is this problem coming up now? What keeps it going?
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
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MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
MY DEVELOPMENT
Page 45
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
I am n not having d difficulty con ncentrating
I feel ready to staart my day
I am n not feeling o overly anxio ous (high levvel of emottional arousaal, with racin ng heart ratte) but am ‘pumped’ in a go ood way
I am n not bringingg any emotio onal baggagge to work with me from reccent conflictt or issue (in n the last 24 hourss)
I am ffeeling good d about goin ng to work to oday
I am llooking forw ward to seeing people at work today
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
//50
CART Workbook forr DSPs: Modulle 1‐ Positive B Behaviour Sup pport
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MY DEVELOPMENT
KEY PERSON
Add up your rattings to givee a total score
I feel physically w well
UNDERSTANDING BEHAVIOUR
PROACTIVE NTERVENTIONS
I am o open to learrning and neew experien nces
CHANGING CONSEQUENCES
FUNCTIONS OF BEHAVIOUR
I am n not distracte ed by thougghts and feelings about things outside wo ork
TEACHING SKILLS
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
I’m reeady to be fully presentt today at wo ork.
GO FORWARD PLANNING
Resiliency C R Check in Exercise
Rate from m 1 to 5 for hoow true this statemen nt is for you, w where 1 == Strongly Disaggree 2 == Disagree 3 == Neither Agreee nor Disagreee 4 == Agree 5 == Strongly Agreee
RESOURCES
MY DEVELOPMENT
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION
MODULE 1 Resources
Is the Individual expressing a concern or issue / expressing distress ?
Yes
Is the family or a community provider identifying a concern or issue / endorsing distress ?
Yes
UNDERSTANDING BEHAVIOUR
Dual Diagnosis Decision Tree
None Identified
Continue to support the individual
Yes
Alter or Adjust environment or supports / implement behavioural intervention resolution?
No Yes
None Identified
Investigate Emotional / Psychological origins: (consider developmental or diagnostic manifestations) Is there an historical or recent traumatic event? Is there a dynamic of transference or countertransference in the client, family or providers? Is there situational stress which could provoke stress based responses?
Yes
Intervention - group or individual resolution?
No
Investigate / assess for a Psychiatric Diagnosis: Psychiatric assessment / consultation for diagnostic clarity
Continue to support the individual
Yes
Yes
Continue to support the individual
TREAT Adopted from Bradley & Summers, 1999 in Dual Diagnosis: NADD 2002
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
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Yes
FUNCTIONS OF BEHAVIOUR
resolution? No
Investigate Environmental / Social origins: Is there a change away from baseline? Is there a change in behaviour? Has there been a change in social interactions / activities / motivation? Have there been changes in staff / environment / expectations ? Has there been a change within family or dynamics? Is this occuring in all settings?
TREAT
TEACHING SKILLS
None Identified
Yes
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Investigate Biological / Medical origins: Inquire or assess for: neurological, acute illness, dental, hearing, metabolic, medication related, GI disruptions, pain
CHANGING CONSEQUENCES
Gather information from the individual, family, providers to understand issue or concern / clarify need. Clarify or establish developmental disability.
GO FORWARD PLANNING
Continue to support the individual
RESOURCES
No
PROACTIVE NTERVENTIONS
No
KEY PERSON
MY DEVELOPMENT
POSITIVE BEHAVIOUR SUPPORTS
Resource 1: Dual Diagnosis Decision Tree
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES
Common “Problem” Behaviours and Speculations about their causes (Ruth Myers, MD, James Salbenblatt, MD, Melodie Blackridge, MD)
High Pain Tolerance A lot of experience with pain Fear of expressing opinion
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS GO FORWARD PLANNING
Biting side of hand/whole mouth
Gastroesophageal reflux
Eustachian tube/ear problems
Eruption of teeth
Sinus problems
Asthma
Eruption of wisdom teeth
Neuropathy (disease of the nerves) / many causes
Rumination
Dental Problems
Nausea
Paresthesias/painful sensation (e.g., pins and needles) in the hand
Uneven seat
Odd un‐ pleasurable masturbation
Hip Pain Genital discomfort Rectal discomfort
Prostatitis Urinary tract infection Pinworms
Biting thumb / objects with front teeth Sinus problems Ears/Eustachian tubes Biting with back teeth Dental Otitis (ear)
Waving head side to side
Intense rocking / preoccupied look
Declining peripheral vision or reliance on peripheral vision
Visceral pain
Walking on toes
Candidal vagina
Headache Depression
Arthritis in ankles, feet, hips or knees
Repetition phenomena, Post‐ Traumatic Stress Disorder
Tight heel cords
Whipping head forward
Left‐handed or fingertip handshake
Waving fingers in front of eyes
Frightening previous setting
Anxiety disorder
Atlantoaxial dislocation (dislocation between vertebrae in the neck)
Dental problems
Migraine; Cataract Seizure Rubbing caused by blepharitis (inflammation of eyelid) or corneal abrasion
Won’t sit Akathisia (inner feeling of restlessness) Back pain Rectal problem
Pain in hands/arthritis
MY DEVELOPMENT
KEY PERSON
RESOURCES
Fist jammed in mouth/down throat
Delirium
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Resource 2: Common Problem Behaviours and Possible Causes
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
(Ruth Myers, MD, James Salbenblatt, MD, Melodie Blackridge, MD)
Migraine Dental
Tic or other movement disorder
Seizure
Seizures
Otitis (ear ache)
Severe sensory integration deficits
Mastoiditis (inflammation of Post‐Traumatic bone behind the ear) Stress Disorder Sinus problems Parasthesias Tinea capitis (fungal infection in the head)
Sticks, rocks, other jagged objects: endogenous opiate addition. Dirt: iron or other deficiency state Feces: Post Traumatic Stress Disorder, psychosis
General scratching
Scratching stomach
Eczema
Gastritis; Ulcer
Scabies
Stretched forward
Pancreatitis (also pulling at back)
Asthma
Gastroesphageal reflux
Pneumonia
Hip/back pain
Porphyria (bile pigment that causes, among other things, skin disorders)
Gastroesophageal reflux
Back pain
Costochondritis/”slip ped rib syndrome” Angina
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
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FOUNDATION MY DEVELOPMENT
KEY PERSON
Gall bladder disease
GO FORWARD PLANNING
Liver/renal disorders
Scratching/hugging chest
RESOURCES
Drug effects
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
Pain
Otitis (thrown off balance by problems in the ear)
Depression
TEACHING SKILLS
Vertigo
Pain
Self‐restraint / binding
CHANGING CONSEQUENCES
General: Obsessive Atlantoaxial Compulsive Disorder, dislocation (dislocation hypothalamic between vertebrae problems, history of in the neck) under‐stimulating environments Cardiac problems Cigarette butts: Seizures nicotine addition, Syncope/orthostats generalized anxiety is (fainting or light‐ disorder headedness caused Glass: suicidality by medication or Paint chips: lead other physical intoxication conditions)
Head banging
FUNCTIONS OF BEHAVIOUR
Pica
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Sudden sitting down
POSITIVE BEHAVIOUR SUPPORTS
Common “Problem” Behaviours and Speculations about their causes
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
Resource 3: Biopsychosocial Formulation Grid
BIOPSYCHOSOCIAL FORMULATION GRID
UNDERSTANDING BEHAVIOUR
PROACTIVE NTERVENTIONS
Psychological
Social
Medical Genetic Medication
Emotional Cognitive Behavioural
Supports, Family, Internal & External Resources
Historical Factors Predisposing
CHANGING CONSEQUENCES
Biological
FUNCTIONS OF BEHAVIOUR
Contributing & Sustaining Factors
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
Precipitating Perpetuating
Strengths & Resources Protective
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
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CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
Resource 4: Dual Diagnosis Psychopathology Screening Questions Dual Diagnosis Psychopathology Screening Questions
5
UNDERSTANDING BEHAVIOUR
Has the person lost interest in preferred activities?
7
Has the person shown some impairment in his or her perception of reality (e.g. responds to internal voices, displays beliefs which are obviously false)?
GO FORWARD PLANNING
6
Has the person experienced some decrease in his or her overall level of motivation?
CART Workbook for DSPs: Module 1‐ Positive Behaviour Support
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MY DEVELOPMENT
KEY PERSON
RESOURCES
4
Has the person experienced decreased involvement with other people?
CHANGING CONSEQUENCES
Has the person experienced a decreased ability to adapt to the demands of daily living (e.g. deterioration in self‐care)?
FUNCTIONS OF BEHAVIOUR
3
PROACTIVE NTERVENTIONS
Is there little or no improvement in the person’s behaviour despite the application of consistent, high quality behavioural programming, as well as confirmation that there is no biological/medical origin?
TEACHING SKILLS
2
Is there a significant change in the person’s behaviour or mood that occurs in all settings rather than some settings?
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
1
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS
Principles: The main goal of Positive Behaviour Support is to use proactive strategies to increase behaviours that will help a person live a more independent and enjoyable life and to decrease behaviours that interfere with independence, enjoyment, and quality of life. All behaviour occurs for a reason and does not occur in a vacuum: it has a context and serves a function for the person. When a behaviour, which may or may not be 'challenging', interferes with relationships and participation, we must first define the behaviour objectively. Learning Direct Support Professions will be able to: Outcomes: Observe behaviour and describe/define it in measurable terms Articulate beliefs about challenging behaviours
Identify how Positive Behaviour Support approaches can help in supporting people with challenging behaviours
Understand behaviour in context – the ABCs
Knowledge/ Skill Areas
1. Defining Behaviour 2. Beliefs about Behaviour 3. Behaviour in Context
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
MODULE 2 | Understanding Behaviour
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CART Workbook for DSPs: Module 2‐ Understanding Behaviour
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
MY DEVELOPMENT
Page 57
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 2‐ Understanding Behaviour
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
MY DEVELOPMENT
Page 59
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 2‐ Understanding Behaviour
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 2‐ Understanding Behaviour
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
MY DEVELOPMENT
Page 63
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 2‐ Understanding Behaviour
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
KEY PERSON
Time 2
CART Workbook for DSPs: Module 2‐ Understanding Behaviour GO FORWARD PLANNING
Time 1
RESOURCES
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
TANTRUM
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MY DEVELOPMENT
FUNCTIONS OF BEHAVIOUR
Exercise: Defining Behaviour Develop and write down a clear and complete ‘operational’ definition for TANTRUM: CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT TEACHING SKILLS
RESOURCES
KEY PERSON
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
FUNCTIONS OF BEHAVIOUR
Observations of Charlie’s behaviour:
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CART Workbook for DSPs: Module 2‐ Understanding Behaviour
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
Page 67
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Exercise: Charlie at the Dinner Table Write an operational definition of Charlie’s behaviour: CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 2‐ Understanding Behaviour
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
MY DEVELOPMENT
Page 69
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Observations of Charlie’s behaviour:
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CART Workbook for DSPs: Module 2‐ Understanding Behaviour
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
Page 71
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
TEACHING SKILLS
RESOURCES
KEY PERSON
Exercise: Charlie at the Dinner Table Write an operational definition of Charlie’s behaviour
MY DEVELOPMENT
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR
TEACHING SKILLS
Yes
John bangs his head on the table loud enough to make a sound Susan becomes impatient
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Lisa attends to her work Terry displays a hostile attitude Will grabs Anna by the arm hard enough that he leaves a red mark and she screams Jackie chooses a leisure material by pointing to the one Anna becomes upset Stephen says “I need a break”
RESOURCES KEY PERSON
Behaviour Mary smiles
GO FORWARD PLANNING MY DEVELOPMENT
No
Jason arrives at work by 8:00 a.m. Charlie freaks out after dinner Charlie banged the table moderately hard 7 times before getting up from the table, so hard that a dish fell off the edge. Page 72
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 2‐ Understanding Behaviour
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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CART Workbook for DSPs: Module 2‐ Understanding Behaviour
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Observations:
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CART Workbook for DSPs: Module 2‐ Understanding Behaviour
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR TEACHING SKILLS
What are the beliefs here? ____________________________________________________________________________
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
____________________________________________________________________________ Is Anna biased? If so, in what way? ____________________________________________________________________________
GO FORWARD PLANNING
How do Anna’s biases impact Amy’s behaviour? ____________________________________________________________________________
RESOURCES
What strategies could Anna use to recognize her biases? ____________________________________________________________________________
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MY DEVELOPMENT
KEY PERSON
____________________________________________________________________________
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
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CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT TEACHING SKILLS
RESOURCES
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
KEY PERSON
GO FORWARD PLANNING
FUNCTIONS OF BEHAVIOUR
Observations:
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CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 2‐ Understanding Behaviour
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COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
RESOURCES
TEACHING SKILLS
KEY PERSON
FUNCTIONS OF BEHAVIOUR
MY DEVELOPMENT
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
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CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Demonstrate cooperative communication skills in interactions
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Knowledge/ Skill Areas
1. Understanding Setting Event and Antecedent Interventions 2. Communication 3. Choice Making
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MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions
Describe the impact of the support environment on behaviour and identify alterations
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Learning Direct Support Professionals will be able to: Outcomes: Identify specific ways to prevent problems through skill teaching and environmental changes Describe their own impact and role in setting and antecedent events
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Proactive interventions that alter the environment, teach skills, and support positive relationships and participation, promote enhanced quality of life and are effective at preventing behaviours which interfere with community participation.
UNDERSTANDING BEHAVIOUR
Principles: The quality of the person’s life depends in large part on their environment—where they live, work, and play. The environment also means whom the person interacts with on a day‐to‐day basis, as well as the quality of those interactions.
PROACTIVE NTERVENTIONS
CHANGING CONSEQUENCES
MODULE 3 | Proactive Interventions
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
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FOUNDATION
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
MY DEVELOPMENT
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
RESOURCES
KEY PERSON
TEACHING SKILLS
MY DEVELOPMENT
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS KEY PERSON
RESOURCES
GO FORWARD PLANNING MY DEVELOPMENT
The following proactive strategies are included in Randy’s Behaviour Support Plan: Proactive Approaches Increase staffing ratio for Randy Staffs are to wear protective sleeves when working one‐to‐one with Randy and all other staff are to wear long sleeves and layers when working in the residence. Peers are encouraged to do the same. Staffs are to provide as much attention as possible—Randy does not like TV, this is not a good activity for him. Actively try to find activities that he likes and that he can do by himself. If staffs need to go to another area of the house, bring him with you and find something for him to do nearby. Chat with him every 2‐3 minutes. Have Randy help staff with chores around house. He does not mind being given instructions such as “can you help me?”, “sweep the floor”, “carry this for me”. He also enjoys cooking (enjoys stirring food in pots). Keep Randy active during the day to use up his energy—running/walking on trails or indoor track, swimming at rec center Tell Randy when you cannot provide one‐to‐one attention. For example: “I need to answer the phone; I’ll be back in 5 minutes.” Praise him when you return to the room. “You did a great job waiting!” Be as quick as possible when you do need to leave him. Page 94
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FOUNDATION
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions
POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR
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TEACHING SKILLS
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
Questions about these strategies:
RESOURCES
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
Skill Building Teach appropriate functional skill of asking for staff to sit with him or do an activity with him Teach tolerance to being away from others – up to 10 minutes Use Assessment of Functional Living Skills to determine skills that staff can teach him – functional 1:1 time Teach leisure skills – increase the amount of time he spends on known activities and find new activities that interest Randy
KEY PERSON
When staff need to pay attention elsewhere, set Randy up with a preferred activity Praise him when you return to the room. “You did a great job waiting!” When Randy is using appropriate behaviours provide him with high quality, 1:1 attention
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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RESOURCES
GO FORWARD PLANNING
Proactive Strategies
Antecedent Event Interventions
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions Setting Event Interventions COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Antecedent Event
KEY PERSON
Setting Event
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
MY DEVELOPMENT
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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FOUNDATION
What was the Antecedent? ____________________________________________________________________________ ____________________________________________________________________________ How could the Antecedent be changed to eliminate this behaviour? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
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GO FORWARD PLANNING
RESOURCES
KEY PERSON
____________________________________________________________________________
MY DEVELOPMENT
____________________________________________________________________________
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
What was the Behaviour?
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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FOUNDATION UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES
Antecedent Interventions: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ CART Workbook for DSPs: Module 3 ‐ Proactive Interventions
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COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
____________________________________________________________________________
GO FORWARD PLANNING
Setting Events to consider: ____________________________________________________________________________
RESOURCES
Antecedent: ____________________________________________________________________________
KEY PERSON
MY DEVELOPMENT
POSITIVE BEHAVIOUR SUPPORTS
Behaviour: ____________________________________________________________________________
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
GO FORWARD PLANNING
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions Strategies to Address Barrier
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TEACHING SKILLS
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Barrier to Implementation
RESOURCES
FUNCTIONS OF BEHAVIOUR
MY DEVELOPMENT
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Other proactive strategies:
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MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
RESOURCES
TEACHING SKILLS
KEY PERSON
FUNCTIONS OF BEHAVIOUR
Observations:
MY DEVELOPMENT
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
How my Focus Individual communicates generally: Communicates a want/need? Communicates pain? Communicates likes / dislikes? Strategies to enhance communication:
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COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
TEACHING SKILLS
RESOURCES
KEY PERSON
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
MY DEVELOPMENT
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Observations:
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CART Workbook for DSPs: Module 3 ‐ Proactive Interventions
KEY PERSON
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COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
GO FORWARD PLANNING
RESOURCES
FUNCTIONS OF BEHAVIOUR
MY DEVELOPMENT
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Video Clip 1 Observations:
Video Clip 2 Observations:
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
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TEACHING SKILLS
MY DEVELOPMENT
FOUNDATION
Exercise: Active Listening and Communication Think of a specific time when you could have used active listening with your Focus Person:
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
What could you do to build active listening into your relationship more consistently?
RESOURCES KEY PERSON
GO FORWARD PLANNING MY DEVELOPMENT
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FOUNDATION
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
CHANGING CONSEQUENCES
FUNCTIONS OF BEHAVIOUR
How does your environment support or not support this person to communicate effectively?
RESOURCES
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MY DEVELOPMENT
KEY PERSON
POSITIVE BEHAVIOUR SUPPORTS
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
What are some key strategies to enhance communication with your Focus Person?
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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CART Workbook for DSPs: Module 3 ‐ Proactive Interventions
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
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FUNCTIONS OF BEHAVIOUR
Your Focus Individual’s Personal Choices
TEACHING SKILLS
Your Personal Choices
MY DEVELOPMENT
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Observations:
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions POSITIVE BEHAVIOUR SUPPORTS
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TEACHING SKILLS
MY DEVELOPMENT
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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FOUNDATION
Direct Support Professional Homework to Complete for Day 2
Priority behaviour of concern (operational definition): ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
Consequence
1
FUNCTIONS OF BEHAVIOUR
2
TEACHING SKILLS
3
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
4 5
GO FORWARD PLANNING
b) Identify one proactive strategy that might prevent the behaviour. Proactive strategy to address behaviour: ____________________________________________________________________________ ____________________________________________________________________________
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions
Behaviour
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RESOURCES
Antecedent
KEY PERSON
Date/Time Behaviour Occurred
MY DEVELOPMENT
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
a) Define one priority behaviour of concern. Write an operational definition of that behaviour. Use the ABC chart to document at least 2 occurrences of the behaviour. Be sure to connect with your Coach and ask for feedback/help.
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
Part 1: Observe your Focus Person and connect with your Coach
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
c) Using the Biopsychosocial practice table below, respond to the questions in the left‐ hand column about your Focus Individual.
Biological Medical, Genetic, Medications
INFORMATION
What information do you have?
FUNCTIONS OF BEHAVIOUR
NEED TO KNOW
What else do you need to know?
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
TEACHING SKILLS
UNDERSTANDING BEHAVIOUR
Biopsychosocial Practice Table Social Formal & informal supports, Family, Internal & External resources
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
What questions do you have?
GO FORWARD PLANNING
SOURCE
How will you find out more?
Who will you ask?
Where do you need to look?
MY DEVELOPMENT
KEY PERSON
RESOURCES
Psychological Emotional, Cognitive, Behavioural
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FOUNDATION
What was the impact on your communication with your Focus Person, if any? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Part 3: Use the Resiliency Tools a) Use the Resiliency Checklist on a day when you feel ‘great/energized’ and on a day when you are dreading going into your shift OR use the Resiliency Place exercise when you need refreshing. Write about your experience. How did you feel? ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
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KEY PERSON
____________________________________________________________________________
MY DEVELOPMENT
____________________________________________________________________________
RESOURCES
What worked? ____________________________________________________________________________
PROACTIVE NTERVENTIONS
____________________________________________________________________________
CHANGING CONSEQUENCES
____________________________________________________________________________
FUNCTIONS OF BEHAVIOUR
____________________________________________________________________________
TEACHING SKILLS
What was your experience?
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
a) Find opportunities with your Focus Individual to practice active listening skills.
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
Part 2: Practice Active Listening Skills
FOUNDATION
What didn’t work?
POSITIVE BEHAVIOUR SUPPORTS
______________________________________________________________________ ______________________________________________________________________
UNDERSTANDING BEHAVIOUR
______________________________________________________________________ What could you do differently next time?
PROACTIVE NTERVENTIONS
______________________________________________________________________ ______________________________________________________________________
CHANGING CONSEQUENCES
______________________________________________________________________
FUNCTIONS OF BEHAVIOUR
Part 4: Read about the Key Person (optional) a) To prepare for a Day 2 exercise, read pages 11‐18 of the Key Person and highlight/circle any areas that you would not be able to follow exactly as written as the primary Direct Support Professional for Randy. Make a list of questions and areas where you need clarification.
TEACHING SKILLS
______________________________________________________________________ ______________________________________________________________________
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
Part 5: Prepare for Development Planning a) If there are any areas you would like to learn more about (knowledge) or learn to do (skills), put them on your Development Planning Worksheet in the Workbook.
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
CART Workbook for DSPs: Module 3 ‐ Proactive Interventions UNDERSTANDING BEHAVIOUR
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TEACHING SKILLS
POSITIVE BEHAVIOUR SUPPORTS
Resource 1: Setting Event List
MY DEVELOPMENT
FOUNDATION
MODULE 3 Resources
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Resource 2: Scatter Plot Assessment Tool Sample
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View own behaviour within the ABC paradigm; demonstrate an understanding of the impact Direct Support Professionals have
Understand that consequences are integral to teaching new behaviours
Use techniques to determine which activities/things are reinforcing for a person
Use consequences to change/modify behaviour
1. Identifying and Understanding Consequences 2. Changing Consequences, Changing Behaviour
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UNDERSTANDING BEHAVIOUR MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
CART Workbook for DSPs: Module 4 – Changing Consequences
TEACHING SKILLS
Describe the principles of effective reinforcement
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Knowledge/ Skill Areas
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Learning Direct Support Professionals will be able to: Outcomes: Define reinforcement; describe the differences between positive and negative reinforcement Identify the benefits of positive reinforcement
PROACTIVE NTERVENTIONS
Principles: Consequences that follow behaviour affect the future of that behaviour. Direct Support Professionals play a significant role in the way consequences are presented, and therefore on how behaviour is supported or reinforced, both positive behaviours and challenging behaviours. We are delivering consequences all the time and may not be aware of the impact we are having.
CHANGING CONSEQUENCES
FUNCTIONS OF BEHAVIOUR
MODULE 4 | Changing Consequences
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
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FOUNDATION
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 4 – Changing Consequences
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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CART Workbook for DSPs: Module 4 – Changing Consequences
CART Workbook for DSPs: Module 4 – Changing Consequences
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS
CART Workbook for DSPs: Module 4 – Changing Consequences
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KEY PERSON
MY DEVELOPMENT
____________________________________________________________________________
RESOURCES
____________________________________________________________________________ ____________________________________________________________________________
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
Specific example of how you reinforced the behaviour of a person you supported on your last shift: ____________________________________________________________________________
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
Examples of how you have been reinforced today: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 4 – Changing Consequences
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 4 – Changing Consequences
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 4 – Changing Consequences
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Effect consequences had on behaviour of the person: What reinforced the person? Other consequences:
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CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Find quick sellf‐care rittuals to fiit into yoour day. Thinkk of simple ways to make ttime for yyourself even d during a b busy workday. Can n you takke mini breakks, or have a ritual at lunch where yyou listen to 10 minutess of your favouritee music? A walk to o the corrner and back? G Go to a quiet spacce, close yyour eyess and go tto your Resilien ncy Spot ffor even 5 minute es? A few w yoga poostures? W What wo ould workk for you??
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MY DEVELOPMENT
KEY PERSON
CART W Workbook for DSPs: Module e 4 – Changingg Consequences
FUNCTIONS OF BEHAVIOUR TEACHING SKILLS
R Resilien ncy Tip
MY DEVELOPMENT
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CART Workbook for DSPs: Module 4 – Changing Consequences
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 4 – Changing Consequences
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS KEY PERSON
RESOURCES
GO FORWARD PLANNING MY DEVELOPMENT
What your Focus Individual enjoys doing: What your Focus Individual enjoys about where he/she lives: Actual ‘reinforcer’ for your Focus Individual: How you know this: How you could use this information to reinforce positive behaviours and prevent challenging behaviours:
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CART Workbook for DSPs: Module 4 – Changing Consequences
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES
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MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
Source: Kathie F. Nunley. Why punishment‐based systems don’t work, yet we’re stuck with them. (www.brains.org)
CART Workbook for DSPs: Module 4 – Changing Consequences
FUNCTIONS OF BEHAVIOUR TEACHING SKILLS
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Punishment teaches fear, aggression and avoidance.
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 4 – Changing Consequences
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 4 – Changing Consequences
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 4 – Changing Consequences
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS
Resource 1: Principles of Reinforcement in Skill Teaching There are seven critical principles that must be followed when implementing reinforcement strategies for teaching skills (Hundert et al): 1. Immediate – reinforcement must be delivered immediately after the performance of the target behaviour to minimize the risk of reinforcing other non‐target behaviours. 2. Contingent – reinforcement is provided only for the performance of the target behaviour so that this particular behaviour increases to the expected level of performance.
4. Paired – all non‐social reinforcers (e.g., activities, tangibles) must be paired with praise that describes the desired behaviour being reinforced so the person knows why they are being reinforced. In addition, these non‐social reinforcers can eventually be faded while being maintained with praise. 5. Frequent – reinforcement needs to be frequent when teaching a new skill and then systematically faded as the skill becomes mastered. 6. Effective – reinforcers are only considered effective if they increase the target behaviour. Reinforcers will maintain their effectiveness longer if they are not provided to the person outside of the training session and if they are varied. 7. Brief – reinforcement provided within the training session should only last 1‐2 seconds so that it does not interfere with the flow of the task being learned.
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
FUNCTIONS OF BEHAVIOUR
3. Enthusiastic – reinforcement has to be given in a very genuine but enthusiastic manner in order to increase its effectiveness.
TEACHING SKILLS
CHANGING CONSEQUENCES
Module 4 Resources
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UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Learn how to dig deeper to understand the functions of behaviour
Understand the purpose of a Functional Behaviour Assessment
Gather information and use tools to contribute to a Functional Behaviour Assessment
Recognize how the functions of behaviour contribute to understanding behaviour
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Learning Direct Support Professionals will be able to: Outcomes: Identify and understand the functions of behaviour Give examples of the 4 main functions of behaviour
PROACTIVE NTERVENTIONS
Principles: Before designing interventions or building skills to address problem behaviours, it is imperative to understand why a behaviour is happening, what purpose it serves, or what the function of the behaviour is. Identifying the function of behaviour requires input from Direct Support Professionals and significant others. Qualitative questions with supporters and accurate data collection from direct observation is required to ensure that functions are correctly identified. Once the function of the specific behaviour is understood and confirmed, then interventions can be effective, and skills can be taught which will have the equivalent function. The result is that the challenging behaviour is no longer needed.
CHANGING CONSEQUENCES
MODULE 5 | Functions of Behaviour
GO FORWARD PLANNING
1. Identifying Functions of Behaviour 2. Contributing to a Functional Behaviour Assessment
RESOURCES
Knowledge/ Skill Areas
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MY DEVELOPMENT
KEY PERSON
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
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FOUNDATION
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
MY DEVELOPMENT
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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FOUNDATION TEACHING SKILLS
THE MESSAGE Pay attention to me. I need help. I want to connect with you socially.
Obtain materials/activities
I want to use the _______. I want the _______. I want to watch/listen to ______.
Obtain sensory stimulation/pain attenuation
This movement feels good; is calming. This makes my headache feel better.
Escape/avoid sensory stimulation
This noise is too loud. This room is too hot.
Escape/avoid attention/social interaction
I don’t want to talk to you. I don’t want you to look at me. I am anxious when interacting socially.
Escape/avoid materials/activities /demands
This is too hard; I don’t know how to do it. I don’t want to be in this activity. I need a break; I don’t like doing this.
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Obtain attention/social interaction
MY DEVELOPMENT
FUNCTION
Some examples of Functions and the Messages they may communicate
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
Working with a Behaviour Consultant The Big 6 Questions The Behaviour Consultant will ask you:
UNDERSTANDING BEHAVIOUR
1. What are _____’s greatest strengths and interests? 2. What specifically is ___ doing that is of concern to you? 3. Under what circumstances do these behaviours occur most? What?
Where?
When?
PROACTIVE NTERVENTIONS
4. Under what circumstances do these behaviours occur least?
CHANGING CONSEQUENCES
Who?
6.
Who?
What?
Where?
When?
5. What do you think _____ gets or avoids through these behaviours?
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Is there anything else you think might be affecting _____’s behaviour?
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 5 – Functions of Behaviour
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
RESOURCES
KEY PERSON
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Primary Function:
Observations:
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CART Workbook for DSPs: Module 5 – Functions of Behaviour
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MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 5 – Functions of Behaviour
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
ABC Checklist (Developed by T. Makela, LRCSS)
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CART Workbook for DSPs: Module 5 – Functions of Behaviour
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
ABC Chart
Antecedent
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Behaviour Consequence
CART Workbook for DSPs: Module 5 – Function of Behaviour
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
CART Workbook for DSPs: Module 5 – Functions of Behaviour
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MODULE 5 Resources
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Resource 1: Completed ABC
Checklist (Developed by T. Makela, LRCSS)
CART Workbook for DSPs: Module 5 – Function of Behaviour
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
CART Workbook for DSPs: Module 5 – Functions of Behaviour UNDERSTANDING BEHAVIOUR
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TEACHING SKILLS
POSITIVE BEHAVIOUR SUPPORTS
MY DEVELOPMENT
FOUNDATION
ABC Checklist (Developed by T. Makela, LRCSS)
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES
Antecedent
Behaviour
Anna is in a conversation with Jenny and Ben comes into room and says ‘eat’. Anna says ‘just wait’, ‘you’ll have to wait’ ‘I know you want something’ but does not take action to respond.
Consequence
Ben slaps Anna on the leg.
Anna speaks kindly to Ben and accompanies Ben to the kitchen to get a cup of coffee
Setting
Antecedent
Behaviour
Events +
Events →
→
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Lou starts shouting and storms out of the building.
Lou goes to his worker’s office and is not required to return to the group until activity is over.
New people are picked up on Anne’s van ride home from the day program and are coming to the group home for dinner. The van is noisier than usual.
Anne becomes very agitated, grabs one of the other residents that she knows well and drags her out of the kitchen and the house.
The Direct Support Professional redirects Anne back to the kitchen and offers her a snack, then tries to engage her in cleaning up.
When they get into the house, everyone gets involved in getting a snack in the kitchen and they are very high energy, with a lot of commotion and laughter.
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
Maintaining Consequences
Lou has a fight with Day staff brings a new staff before leaving and unknown activity for Day Program. into the morning program.
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Resource 2: Completed Simple ABC Charts
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CART Workbook for DSPs: Module 5 – Functions of Behaviour
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MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Resource 3: Functional Behaviour Assessment Interview Form
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
The Functional Behavioural Assessment Process: Step‐by‐step Keep in mind that before Step 1 you will have investigated any underlying medical or psychiatric issues which may contribute to the person’s behaviour.
Step 1: Identify, Prioritize and Define Problem/ Challenging Behaviour(s)
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
Resource 4: Functional Behaviour Assessment Process
CHANGING CONSEQUENCES
Step 2: Conduct a Functional Assessment Gather Broad Information
FUNCTIONS OF BEHAVIOUR
Step 3 Develop Hypothesis Statement
TEACHING SKILLS
Step 4: Develop the Behaviour Support Plan Antecedent/ Setting Event Interventions
Alternative Skill Instruction
Responses to Problem Behaviour
Long-Term Supports
Step 5: Implement, evaluate, and modify
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Gather Specific Information
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CART Workbook for DSPs: Module 5 – Functions of Behaviour
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MY DEVELOPMENT
KEY PERSON
RESOURCES
2
1 Date: Intervention Frequency Intervention:
4
5
GO FORWARD PLANNING
Baseline
3
7
9
10
11
12
13
14
TEACHING SKILLS
_______________________________
8
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
6
16
17
18
19
20
21
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
_______________________________
15
23
24
25
26
27
28
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
_______________________________
22
30
31
POSITIVE BEHAVIOUR SUPPORTS
____________ _
29
20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 0
FOUNDATION
Resource 5a: Frequency Tracking Sheet
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Resource 5b: Intensity Tracking Sheet
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CART Workbook for DSPs: Module 5 – Functions of Behaviour
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MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Resource 5c: Duration Tracking Sheet
Principles:
FOUNDATION PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
MODULE 6 | Teaching Skills
Learning Outcomes:
Behaviours that challenge may reflect a skill deficit. Building skills (generally to increase positive communication and independence) will lessen challenging behaviours. Learning socially significant skills, as well as skills that will increase independence will increase quality of life, allow participation in meaningful activity and increase self‐esteem. Direct Support Professionals will be able to:
Articulate the difference between types of skills and priority skills to teach
Use skill assessment and task analysis tools and processes to identify needs
Build a skill teaching plan
Demonstrate skill teaching strategies: delivering instructions, modeling, and prompting
Describe how to support skill use
Knowledge/ Skill Areas
1. Choosing Skills to Teach 2. Building a Skill Teaching Plan 3. Using Skill Teaching Strategies
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
MY DEVELOPMENT
KEY PERSON
RESOURCES
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CART Workbook for DSPs: Module 6 – Teaching Skills
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MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 6 – Teaching Skills
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 6 – Teaching Skills
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
Exercise: Assessing Functional Skills to Teach My Focus Individual Functional Skill
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
MY DEVELOPMENT
KEY PERSON
RESOURCES
Page 198
Priority (1, 2, 3 etc.)
Aligned with Person Directed Plan?
Would this skill increase…
How Check would it do √ that?
Independence?
Quality of Life?
Capacity for Involvement?
Independence?
Quality of Life?
Capacity for Involvement?
Independence?
Quality of Life?
Capacity for Involvement?
Independence?
Quality of Life?
Capacity for Involvement?
CART Workbook for DSPs: Module 6 – Teaching Skills
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 6 – Teaching Skills
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
MY DEVELOPMENT
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 6 – Teaching Skills
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
MY DEVELOPMENT
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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0 1 2 3 4
Learner will answer “What” questions regarding items found in the home, school, and the community.
Learner will answer “where” questions regarding items found or activities done at home, school, and the community
Learner will provide answers to questions regarding personal information
TASK OBJECTIVE
TEACHING SKILLS CHANGING CONSEQUENCES
4=answers 50 or more questions including at least 10 examples from home, school and community, 3=40 questions, 2=20 questions, 1=answers at least 10 questions pertaining to home, school, or community
When learner is asked, “What can you find in the bathroom?” learner says, “Toilet, bathtub, towels,” What can you find in the nurse’s office?” learner says, “Band aids, thermometer.” When asked, “What do you do at the park?” learner says, “Play on the swings and slide.” Does learner answer What” questions regarding items found in home, school, or the community?
4=answers 50 or more questions including at least 10 examples from home, school, and community, 3=40 questions, 2=20 questions, 1=answers at least 10 questions pertaining to home, school, or community
When learner is asked “Where do you sleep?” learner says, “Bedroom”, When learner is asked “Where do you play basketball?” learner says, “Gym”, When asked, “Where do we buy milk?” learner says, “Grocery store.”
Does learner answer “Where” questions regarding items found and activities done at home, school, or the community?
COMMENT
UNDERSTANDING BEHAVIOUR
4=at least 4 pieces of information about self (e.g., name, age, hone, siblings, parents’ names, etc.) 3=3 pieces of information, 2= 2 pieces of information, 1 = 1 piece of information about self
CRITERIA
PROACTIVE NTERVENTIONS
When asked, “What’s your name?” learner will state name.
EXAMPLE
FUNCTIONS OF BEHAVIOUR
Can learner provide information about self?
QUESTION
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
POSITIVE BEHAVIOUR SUPPORTS
BC 17
0 1 2 3 4
BC 16
SCORE
0 1 2 3 4
TASK
RESOURCES
BC 15
KEY PERSON
GO FORWARD PLANNING
FOUNDATION
Basic Communication Skills (3 sample tasks taken from The Assessment of Functional
Living Skills – The AFLS TM)
CART Workbook for DSPs: Module 6 – Teaching Skills
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 6 – Teaching Skills
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
MY DEVELOPMENT
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 6 – Teaching Skills
Page 205
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 6 – Teaching Skills
Page 207
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
Exercise: Clarity of Instructions: 1. 2. 3.
CART Workbook for DSPs: Module 6 – Teaching Skills GO FORWARD PLANNING
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COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
MY DEVELOPMENT
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
CART Workbook for DSPs: Module 6 – Teaching Skills POSITIVE BEHAVIOUR SUPPORTS
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TEACHING SKILLS
MY DEVELOPMENT
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 6 – Teaching Skills
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TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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Skill Teaching Strategies:
CART Workbook for DSPs: Module 6 – Teaching Skills
Page 215 COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
RESOURCES
KEY PERSON
TEACHING SKILLS
MY DEVELOPMENT
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
PROACTIVE NTERVENTIONS
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CHANGING CONSEQUENCES
GO FORWARD PLANNING
Steps in Task Analysis Chain
Page 216
Type of Prompt Used
CART Workbook for DSPs: Module 6 – Teaching Skills
FOUNDATION
CART Workbook for DSPs: Module 6 – Teaching Skills
Page 217 COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
RESOURCES
KEY PERSON
TEACHING SKILLS
MY DEVELOPMENT
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Physical Prompting Hierarchy
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Full physical – gentle hand over hand guidance to complete the task Partial physical – guidance by holding learner at wrist, forearm, elbow, upper arm
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
Shadow – your hand follows learner actions to ensure the accurate movement Gesture – pointing, motioning the accurate movement Independent – no physical prompting, may systematically increase distance to learner
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CART Workbook for DSPs: Module 6 – Teaching Skills
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POSITIVE BEHAVIOUR SUPPORTS
UNDERSTANDING BEHAVIOUR
PROACTIVE NTERVENTIONS
CHANGING CONSEQUENCES
FUNCTIONS OF BEHAVIOUR
TEACHING SKILLS
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
RESOURCES
KEY PERSON
Type of Prompt
MY DEVELOPMENT
Steps in Task Analysis Chain √ FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
CART Workbook for DSPs: Module 6 – Teaching Skills
Page 221
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
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FOUNDATION FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
Needed often
Age appropriate activity
Increases participation/ quality of life
Socially significant
KEY PERSON
Increases independence
RESOURCES
√
CART Workbook for DSPs: Module 6 – Teaching Skills
Page 223
MY DEVELOPMENT
Criteria
GO FORWARD PLANNING
Check whether this skill conforms to guidelines for selecting a functional skill:
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
Priority Skill for your Focus Person to learn (from previous exercise):
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COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
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UNDERSTANDING BEHAVIOUR
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Making the Link Collaborating and Contributing to Behaviour Support Plans Implementing and Problem Solving Behaviour Support Plans Debriefing
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1. 2. 3. 4.
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Knowledge/ Skill Areas
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Learning Direct Support Professionals will be able to: Outcomes: State the goals, components, and areas of focus of a Behaviour Support Plan Articulate the connection between a Person Directed Plan and Behaviour Support Plan State their contribution to the development of a Behaviour Support Plan Identify roles of staff and stakeholders in development and monitoring of Behaviour Support Plan Collect data to determine if the Behaviour Support Plan is working Identify barriers to data collection and implementation and how to overcome them Monitor the impact of a Behaviour Support Plan Understand and use debriefing strategies
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Direct Support Professionals have valued contributions to make to the development and implementation of a Behaviour Support Plan. They need to understand why it is being done, to contribute fully and to implement recommendations. They also need to identify when expectations are unrealistic or beyond their skill set. Developing and implementing a Behaviour Support Plan is a collaborative effort. A Behaviour Support Plan must be followed as written, and if this is not possible, new strategies will need to be developed. Call for help whenever this is the case. Effective implementation of a Behaviour Support Plan will generally require training and coaching, as individualizing means that the Direct Support Professional responses will be different for each person and related to each target behaviour.
MY DEVELOPMENT
Principles:
POSITIVE BEHAVIOUR SUPPORTS
MODULE 7 | Collaborating to Address Challenging Behaviours
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RESOURCES
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MY DEVELOPMENT
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RESOURCES
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MY DEVELOPMENT
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RESOURCES
GO FORWARD PLANNING
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What was your role? ____________________________________________________________________________ ____________________________________________________________________________ What was the outcome for the person? ____________________________________________________________________________ ____________________________________________________________________________ CART Workbook for DSPs: Module 7 – Collaborating to Address Challenging Behaviours
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____________________________________________________________________________
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____________________________________________________________________________
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What did your team do?
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Individually reflection on time when working with a Behaviour Consultant went well:
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RESOURCES
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POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
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RESOURCES
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FOUNDATION
MY DEVELOPMENT
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RESOURCES
GO FORWARD PLANNING
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3. GO FORWARD PLANNING
2.
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Implementation Issue/Barrier
1.
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Questions for Behaviour Consultant Panel about Behaviour Support Plan: 1. ____________________________________________________________________
UNDERSTANDING BEHAVIOUR
____________________________________________________________________
PROACTIVE NTERVENTIONS
2. ____________________________________________________________________ ____________________________________________________________________
CHANGING CONSEQUENCES
3. ____________________________________________________________________ ____________________________________________________________________
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RESOURCES
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Module 7 Resources
Resource 1: Types of Debriefing
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A formal debriefing typically occurs 1‐2 days later. It is led by a senior manager, someone who was not directly involved in event, but is trained in formal debriefing processes. This debriefing would include a broader group of people—the team lead (mandatory attendance), other treatment team members, and advocates (family members) for the person. At the meeting, the manager would set the context by explaining the situation and the purpose of meeting. It is also important to set ground rules for the meeting, such as confidentiality, respectful communication, and emotional safety. After the meeting begins, it is then ‘closed’ in order to ensure stability of the group process. The formal debriefing steps would typically include: 1. Facts: What do we know that happened? 2. Feelings: How do you feel about the events that happened? 3. Planning: What can/should we do next? 4. Operational issues 5. Training issues 6. Identification of triggers 7. Identification of antecedent behaviours 8. Exploration of alternatives used and responses
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
2. Formal debriefing
GO FORWARD PLANNING
Immediately after an event emotions are often so high that blaming, denial, and other defenses may occur. Stay with facts and attempt to address a hierarchy of needs.
RESOURCES
Post‐acute event debriefing is done immediately following the event (with the staff involved and close to or in the area that the incident took place). It is focused on safety, security, Direct Support Professionals (who often do not recognize injury), and the emotions of all involved persons. The debriefing would in some cases include the person. There are several goals: Return to pre‐crisis milieu Ensure that documentation is accurate, complete and meets requirements Gather and communicate event facts to members of the person’s support team, family Begin to evaluate the need for emotional support up to actual trauma treatment
UNDERSTANDING BEHAVIOUR
1. Post‐acute event debriefing
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FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
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UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
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FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
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FOUNDATION
MY DEVELOPMENT
MY DEVELOPMENT
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RESOURCES
GO FORWARD PLANNING
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CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
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FOUNDATION
MY DEVELOPMENT
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RESOURCES
GO FORWARD PLANNING
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RESOURCES Antecedent. Behaviour. Consequence
AFLS
Assessment of Functional Living Skills
ASD
Autism Spectrum Disorder
BPS
Biopsychosocial
BSP
Behaviour Support Plan
CB
Challenging Behaviour
DSP
Direct Support Professional
FAI
Functional Assessment Interview
FBA
Functional Behaviour Assessment
FIDD
Frequency Intensity Duration Discrimination
MAS
Motivation Assessment Scale
PBS
Positive Behaviour Support
PDP
Person Directed Plan
PRN
Pro re nata (typically refers to medication to be given in the circumstances or as needed)
QABF
Questions About Behaviour Function
QOL
Quality Of Life
Sd
Discriminative Stimulus
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ABC
UNDERSTANDING BEHAVIOUR
Glossary of Acronyms
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Glossary of Terms
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Source: Adapted from Rubino, C.A. (Ed.) Changing Behaviour: A comprehensive manual of applied behaviour analysis, 2nd Edition, Toronto: Ontario, Ministry of Community and Social Services (2000) ABC Analysis An ABC Analysis is an examination of the antecedents and consequences of a target behaviour. This analysis is essential in determining the environmental factors which influence the behaviour. It also provides a foundation for the development of appropriate behaviour‐change strategies. Aversive Stimulus A stimulus applied contingently that is likely to cause physical pain or extreme and obvious discomfort. Antecedents Antecedents are the multiple factors that form the situation preceding the occurrence of the behaviour. They do not make the behaviour occur; rather, they provide the occasion for the behaviour to occur. Back‐up reinforcer A back up reinforcer is an item or activity for which tokens are exchanged. Back up reinforcers typically include extra privileges, consumables, and other tangible items for individuals willing to work. Baseline A baseline is a measure of the target behaviour taken prior to implementation of change procedures. Behaviour Behaviour is what the individual is observed to be doing. It is neither good nor bad in itself. Any description of behaviour should include what is actually seen and/or heard, and not a reaction to, interpretation of, or explanation for what was observed. Behaviour Contract Behaviour contract is a written agreement between two or more individuals. It specifies the behaviour(s) required of one individual and the consequence(s) that will be implemented by the other individual(s) contingent on performance of those required behaviour(s). Chaining Chaining is a method of linking together the component behaviours identified in your task analysis. Chaining may be used in a forward or backward direction.
Checklist, use of a A checklist can be used as one method of behaviour measurement. A list of target behaviours is prepared and each behaviour is checked off as it occurs during specified observation periods.
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Consequences Consequences are the multiple factors which constitute the situation that follows a behaviour. They are not necessarily the result of the behaviour. Contingency Contingency is an event planned to occur in the presence of a predetermined stimulus. Contingent observation Contingent observation is a technique involving the temporary withdrawal of the individual from a rewarding group situation following the occurrence of a specified undesirable behaviour. The individual is withdrawn to a nearby area from which he can observe the appropriate behaviour of those individuals remaining in the group. Differential reinforcement Reinforcement given when a pre‐determined response occurs in the presence of a given stimulus such that that stimulus becomes discriminative for the response. Differential reinforcement of alternative behaviours (DRA) Reinforcement of an alternate behaviour involves reinforcement of another more desirable behaviour that is not necessarily incompatible with the undesirable behaviour Differential reinforcement of incompatible behaviour (DRI) Reinforcement of an incompatible behaviour is reinforcement of a desired behaviour that cannot occur (e.g., incompatible or competing) at the same time as the undesirable behaviour that you are attempting to decrease. Differential reinforcement of a low rate of responding (DRL) Reinforcement of a specified behavioural response that occurs at low rates, after a specified interval. Differential reinforcement of other behaviours (DRO) Reinforcement for engaging in another behaviour other than the target behaviour. Discriminative Stimulus (sD) A Discriminative Stimulus is something that is used as a signal that reinforcement will be coming. Escape behaviour Getting away from an unpleasant situation that is already going on. Extinction Extinction is a decreasing technique that involves withholding reinforcement contingent upon the occurrence of the specified undesirable behaviour. It typically involves withholding attention when attention is maintaining the behaviour of concern. Fading (prompts) The fading of prompts involves gradual removal of physical, gestural and verbal cues that have been used to elicit the target behaviour. Prompts are usually withdrawn in the following order: physical prompts, gestural prompts and finally verbal prompts.
FOUNDATION
Maintenance Maintenance is the continued occurrence of the target behaviour during and following the fading out of planned reinforcers. Mediator A mediator is any person who carries out a behaviour‐change program. A mediator could be a parent, teacher, babysitter, workshop supervisor, etc. Modeling Modeling refers to the process by which an individual learns a behaviour by observing the behaviour being performed. This process occurs naturally and may result in the acquisition of either appropriate or inappropriate behaviour. Modeling may be used systematically in an ABC program to prompt (either) the target behaviour in its entirety or discrete components of the complete behaviour. It is typically used in combination with one or more of the other three forms of prompts. Negotiation Negotiation is a discussion between two or more individuals to determine the specifics of a behaviour contract.
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Functional analysis Functional analysis is an analysis of the ecological factors that may impact upon a particular behaviour(s) including a thorough assessment of the following: the events that precede and follow the behaviour; the history of the behaviour; and the physical and environmental factors that may be influencing the behaviour. Generalization Generalization is the occurrence of the target behaviour in environments other than the one in which it was learned. Goal / Objective The achievement of a level of occurrence or extent of the target behaviour predetermined to indicate successful programming. Intermittent schedule of reinforcement An intermittent schedule of reinforcement involves rewarding the individual less than every time the target behaviour occurs. There are two types of intermittent schedules, an interval schedule and a ratio schedule. Intrinsically reinforcing behaviour An intrinsically reinforcing behaviour is a behaviour that is performed because it is innately satisfying to the individual. Performance of this behaviour does not depend on contingent reinforcement from the environment. Least restrictive To employ the least restrictive approach is to plan an intervention that is deemed to be of minimal yet sufficient strength or intrusiveness to effectively influence the behaviour.
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Punishment Punishment is a decreasing technique in which a negative consequence follows the occurrence of a behaviour and results in a decrease in that behaviour. It may involve the addition of an unpleasant consequence or the withdrawal of a pleasant consequence. Recording / measurement a) Duration recording Duration recording is a measurement technique in which you measure the length of time that passes between the start of the target behaviour and its termination.
GO FORWARD PLANNING
Non‐contingent Reinforcement Non‐contingent reinforcement refers to delivery of reinforcing stimuli regardless of the individual’s behaviour, so there is no relationship between the reinforce and the behaviour. Operational definition An operational definition of a target behaviour is a clear and complete description of what can be seen and/or heard. Where appropriate, it will also include some reference to when the behaviour starts and/or stops, possible variations of, exceptions to, and special conditions for the behaviour. Overcorrection Overcorrection is a decreasing technique which involves requiring the individual to expend a great deal of time and effort to "correct" the situation created by his performance of the specified undesirable behaviour. Overcorrection frequently involves additional related tasks in order that performance of the undesirable behaviour and the resulting overcorrection procedure is less appealing than the performance of a more appropriate behaviour. Positive practice Positive practice is a decreasing technique which involves having an individual practice or repeatedly perform an appropriate or correct behaviour following the occurrence of a related inappropriate or incorrect behaviour. The procedure should be sufficiently prolonged and effortful, to make the appropriate or correct behaviour more appealing to perform. Premack principle A more preferred activity (a higher frequency behaviour) is followed by (made contingent upon) a less preferred activity (lower frequency behaviour), and is likely to strengthen or increase the occurrence of the less preferred activity. This is also known as the "First" and "Then" principle. Prompt A prompt is a means of cueing a specific behaviour. A prompt may be verbal, gestural, or physical. a) Verbal prompt A verbal prompt is a command, instruction, or single word from the mediator, used to elicit a specific behaviour in the individual. b) Gestural prompt A gestural prompt is a gestural movement made by the mediator which elicits a specific behaviour in the individual. c) Physical prompt A physical prompt is a physical movement by the mediator to cue or totally guide the individual to perform a specific behaviour.
FOUNDATION
Reinforcement a) Positive reinforcement A reinforcer is positive when a response, if followed by a contingent presentation of a stimulus, increases in its frequency of occurrence. b) Negative reinforcement A reinforcer is a negative when a response, if followed by the contingent removal of a stimulus, increases in its frequency of occurrence. Response‐cost Response‐cost is a form of punishment that may be one aspect of a token economy program. It involves the withdrawal of tokens for the failure to carry out previously defined appropriate behaviours or for performance of previously defined inappropriate behaviours. Reward/positive reinforcer A reward/positive reinforcer is a consequence that increases the likelihood that a behaviour will recur. It is something that the individual "likes" and something for which he is willing to work. It can be used to increase or accelerate a target behaviour. a) Tangible rewards Foods, drinks, objects, tokens, stickers, certificates or money. b) Activity rewards Favoured games or activities (i.e. biking, books, music, T.V., toys, free time) c) Social rewards Praise in the form of words (verbal), physical contact (i.e. pat on back) or gestures (i.e. thumb up). Social rewards are very effective and they can easily be given immediately and in any location. Satiation The loss of effectiveness of a reinforcer that has been presented repeatedly (usually in a short time period).
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
b) Event recording Event recording is a measurement technique in which you record the frequency of the behaviour or how often the behaviour occurs over a specified period of time. Event recording may also be called frequency recording. c) Interval recording Interval recording is a measurement technique in which you divide the designated observation period into equal time intervals and record the occurrence or non‐occurrence of the target behaviour. At any point during the interval, each behaviour is only recorded once per time segment, regardless of the actual frequency of occurrence of that behaviour during the time segment. d) Time sampling Time sampling is a measurement technique in which you collect a representative sample of a frequently occurring behaviour instead of recording every instance of the behaviour and use the sample as an indication or estimate of the overall frequency.
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FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES
FUNCTIONS OF BEHAVIOUR TEACHING SKILLS
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS GO FORWARD PLANNING RESOURCES MY DEVELOPMENT
KEY PERSON
Schedules of reinforcement a) Continuous A continuous schedule of reinforcement involves rewarding the individual each time the target behaviour occurs. b) Intermittent An intermittent schedule of reinforcement involves rewarding the individual less than every time the target behaviour occurs. There are two types of intermittent schedules; an interval schedule and a ratio schedule: i) Interval schedule: An interval schedule is one type of an intermittent schedule of reinforcement in which reinforcement of the target behaviour is related to the passage of time. The behaviour is reinforced only if it occurs within a few seconds after a specified time interval has elapsed. ii) Ratio schedule: A ratio schedule is one type of intermittent schedule of reinforcement in which the reinforcement is administered after a specified number of occurrences of the target behaviour. Shaping Shaping is a procedure in which positive reinforcement is provided for successively closer approximations of the final target behaviour. It is useful for teaching new behaviours and strengthening weak or low‐level behaviours. Target behaviour A target behaviour is a behaviour you want to teach or modify. It should be measurable as well as beneficial and realistic for both the individual and mediator. Task analysis Task analysis is a procedure in which a complex behaviour is analysed or divided into smaller steps that can be learned more easily. Time‐out Time out involves the temporary withdrawal of the individual from a rewarding situation following the occurrence of the undesirable behaviour. It is a punishment technique in that it involves the addition of an unpleasant consequence (see punishment). It also has components of extinction in that attention is withheld. Token A token is a tangible object or symbol that attains reinforcing properties by being exchanged for items or activities for which the individual is willing to work (back‐up reinforcers). Token economy A token economy is a motivational system in which tokens are earned for the performance of previously defined appropriate behaviours and subsequently exchanged for previously defined back‐up reinforcers. Tokens may also be withdrawn for the failure to carry out previously defined appropriate behaviours or for the performance of previously defined inappropriate behaviours (response‐cost).
FOUNDATION
Source: Paclawskyj, T. R., Matson, J. L., Rush, K. S., Smalls, Y., & Vollmer, T. R. (2000). Questions About Behavioral Function (QABF): A behavioral checklist for functional assessment of aberrant behavior. Research in Developmental Disabilities; 21(3), pp.223‐229
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
Questions About Behaviour Function (QABF)
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FOUNDATION UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
M Mindful ness Exercise E e
PROACTIVE NTERVENTIONS
BU UTTERFLY ST TORY
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KEY PERSON
CART W Workbook for DSPs: Resourrces
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
Imagine e there is s a butterfly on yo our chestt… it hass its wings spread s and it is about to ta ake flightt… it see ems more and a more likely to do so ev very time you take ea es)… breath in and ou ut (breath he in and d out slow wly 3 time but it re emains sitting on your che est for some time… … look at the butte erfly care efully… lo ook at the e colour a and ed breath hing)… shape (speak slowly, at the rate of relaxe he butterffly will take flight… … imagin ne followiing the soon th butterfly to a ple easant pllace. A place p where you ffeel relaxed d, comforrtable and d safe… pay care eful atten ntion to the signals s and sound ds, smells, and se ensationss of this pla ace… how w does itt feel, how w do you u feel bein ng here… (take a long l pausse) … allow yours self to be e there and to relax as fully as p possible… … you ca an enjoy tthis place as a long as s want. Rememb ber that you y carryy this peaceful place inside yo ou and yo ou can co ome here e and visit any time yo ou want.
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
References
UNDERSTANDING BEHAVIOUR
Campbell, M. (2007). Staff Training and Challenging Behaviour. Journal of Intellectual Disabilities. Vol. II (2) 143‒156.
PROACTIVE NTERVENTIONS
Anderson J. L., Russo A., Dunlap G. & Albin R. W. (1996). A team training model for building the capacity to provide positive behavioural supports in inclusive settings. In: Positive Behavioural Support: Including People with Difficult Behaviour in the Community (eds L. K. Koegel, R. L. Koegel & G. Dunlap), pp. 467‐ 490. Paul Brookes Publishing, Baltimore, MD.
Carr, E. G. , Dunlap , G. , Horner , R. H. , Koegel , R. L. , Turnbull, A. P. , Sailor , W. & Fox , L . (2002). Positive behavior support: Evolution of an applied science. Journal of Positive Behavior Interventions; Vol. 4; pp. 4 – 20.
Carr et al (2002). Positive Behavior Support: Evolution of an Applied Science. Journal of Positive Behavior Interventions; Vol. 4(1), pp. 4–16, 20
CHANGING CONSEQUENCES
Carr, E. G., & Durand, V. M. (1985). Reducing behavior problems through functional communication training. Journal of Applied Behavior Analysis; Vol. 18; pp. 111 – 126.
FUNCTIONS OF BEHAVIOUR
Carr, E. G. , Horner , R. H. , Turnbull , A. P. , Marquis , J. G. , McLaughlin , D. M. , McAtee , M. L. & Braddock , D . (1999). Positive behavior support for people with developmental disabilities: A research synthesis. Washington, DC: American Association on Mental Retardation. CPI (2013). Nonviolent Crisis Intervention‐Integrating Positive Behavioural Interventions and Supports (PBIS): Leader’s guide. CPI International.
TEACHING SKILLS
Crates, N. & Spicer, M. (2012). Developing behavioural training services to meet defined standards within an Australian statewide disability service system and the associated client outcomes. Journal of Intellectual & Developmental Disability; Vol. 37(3); pp. 196–208.
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Donnellan , A. M. , LaVigna , G. W. , Zambito , J. , & Thvedt , J . (1985). A time‐limited intensive intervention program model to support community placement for persons with severe behavior problems. Journal of the Association for Persons with Severe Handicaps; Vol. 10; pp. 123 – 213. Dunlap, G., Hieneman, M., Knoster, T., Fox, L., Anderson, J. & Albin, R. (2000). Essential Elements of Inservice Training in Positive Behavior Support. Journal of Positive Behavior Interventions; Vol. 2, Number 1, pp. 22‐32.
GO FORWARD PLANNING
Dunlap, G., Carr, E.G., Horner, R., Zarcone, J. & Schwartz, I. (2008). Positive Behavior Support and Applied Behavior Analysis: A Familial Alliance. Behavior Modification; Vol.32, pp. 682‐698.
Elliott, S. N. (1988). Acceptability of behavioural treatments: Review of variables that influence treatment selection. Professional Psychology: Research and Practice; Vol. 19; pp. 68 – 80.
MY DEVELOPMENT
KEY PERSON
RESOURCES
Emerson, E. (2001). Challenging Behaviour: Analysis and Intervention in People with Severe Disabilities. Cambridge University Press, Cambridge. Emerson, E., Cambridge, P., Forrest, S. & Mansell, J. (1993). Community support teams for people with learning disabilities and challenging behaviours. In: Research to Practice? Implications of Research on the Challenging Behaviour of People with Learning Disability (ed. C. Kiernan), pp.229‐244. BILD Publications, Clevedon, Avon. Page 10
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FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
Emerson, E. & Emerson, C. (1987). Barriers to the effective implementation of habilitative behavioral programs in an institutional setting. Mental Retardation; Vol. 25; pp. 101 – 106. Freeman, R., Smith, C., Zarcone, J., Kimbrough, P., Tieghi‐Benet, M., Wickham, D., Reese, M. & Hine, K. (2005). Building a Statewide Plan for Embedding Positive Behavior Support in Human Service Organizations. Journal of Positive Behavior Interventions; Vol. 7(2); pp. 109–119.
UNDERSTANDING BEHAVIOUR
Grey, I. M. & McClean, B. (2007). Service user outcomes of staff training in positive behaviour support using person‐focused training: A control group study. Journal of Applied Research in Intellectual Disabilities; Vol. 20; pp. 6 – 15. Hanley, G. P., Iwata, B. A. , & McCord, B. E . (2003). Functional analysis of problem behavior: A review. Journal of Applied Behavior Analysis; Vol. 36; pp. 147 – 185
Iwata , B. A. , Wallace , M. D. , Kahng , S. , Lindberg , J. S. , Roscoe , E. M. , Conners , J. & Worsdell , A. S . (2000). Skill acquisition in the implementation of functional analysis methodology. Journal of Applied Behavior Analysis; Vol. 33; pp. 181 – 194. Johnston, L., Foxx, R., Jacobson, J., & Green, G. (2006). Positive Behavior Support and Applied Behavior Analysis. The Behavior Analyst; Vol. 29 (1); pp. 51–74.
Kincaid D., Knoster T., Harrower J. K., Shannon P. & Bustamante S. (2002). Measuring the impact of positive behavior support. Journal of Positive Behavior Interventions; Vol 4; pp. 109‐117.
TEACHING SKILLS
Kitchener, B.A., Jorm, A.F., Kelly, C.M., Pappas, R. & Frize, M. (2010). Intellectual Disability Mental Health First Aid Manual. 2nd ed. Melbourne: Mental Health First Aid Australia. Koegel L. K., Kogel R. L. & Dunlap G. (1996). Positive Behavioural Support: Including People with Difficult Behaviour in the Community. Paul Brookes Publishing, Baltimore, MD.
LaVigna , G. W. , Christian , L. , & Willis , T. J . (2005). Developing behavioural services to meet defined standards within a national system of specialist education services. Pediatric Rehabilitation; Vol. 8; pp. 144 – 155. LaVigna, G. W., & Willis , T. J . (1992). A model for multielement treatment planning and outcome measurement. In D. E. Berkell (Ed.), Autism: Identification, education, and treatment. (pp. 135 – 149 ). Hillsdale, NJ: Erlbaum.
RESOURCES
LaVigna, G. W. , & Willis , T. J . (2005). Episodic severity: An overlooked dependent variable in the application of behavior analysis to challenging behavior. Journal of Positive Behavior Interventions; Vol. 7; pp. 47 – 54. LaVigna , G. W. , Willis , T. J. , Shaull , J. F. , Abedi , M. , & Sweitzer , M . (1994). The periodic service review: A total quality assurance system for human services and education. Baltimore, MD: Brookes.
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MY DEVELOPMENT
KEY PERSON
Lowe, K., Jones, E., Allen, D., Davies, D., James, W., Doyle, T., Andrew, J., Kaye, N., Jones, S., Brophy, S. & Moore, K. (2007). Staff Training in Positive Behaviour Support: Impact on Attitudes and Knowledge. Journal of Applied Research in Intellectual Disabilities; Vol. 20, pp.30–40.
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Koyama, T. & Wang, H. (2011). Use of activity schedule to promote independent performance of individuals with autism and other intellectual disabilities: A review. Research in Developmental Disabilities; Vol. 32, pp. 2235–2242.
FUNCTIONS OF BEHAVIOUR
Kincaid, D., Peshak George H. & Childs, K. (2006). Review of the Positive Behavior Support Training Curriculum: Supervisory and Direct Support Editions. Journal of Positive Behavior Interventions; Vol. 8(3); pp. 183–188.
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
Intellectual Disability Rights Service. (2009). Introduction to Intellectual Disability. http://www.idrs.org.au/pdf/IDRS_%20Introduction_intellectual%20disability_17Feb09.pdf. Download ed August, 27, 2014.
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
MacDonald, A., Hume, A. & McGill, P. (2010). The use of multi‐element behaviour support planning with a man with severe learning disabilities and challenging behavior. British Journal of Learning Disabilities; Vol. 38, pp. 280‐285.
UNDERSTANDING BEHAVIOUR
Ministry of Community and Social Services. Quality Assurance Measures, Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008 (SIPDDA), Ontario Regulation 299/10. http://www.e‐laws.gov.on.ca/html/regs/english/elaws_regs_100299_e.htm Moore, M. (2010). Positive Behavior Support Planning in Context: Ensuring, high quality implementation efforts by embedding person‐centered planning into PBS. Presentation. Colorado PBS Network.
PROACTIVE NTERVENTIONS
McClean, B., Dench, C., Grey, I., Shanahan, S., Fitzsimons, E., Hendler, J. & Corrigan, M. (2005). Person Focused Training: a model for delivering positive behavioural supports to people with challenging behaviours. Journal of Intellectual Disability Research; Vol. 49(5); pp. 340‐352. McClean. B. & Grey, I. (2012). A component analysis of positive behaviour support plans. Journal of Intellectual & Developmental Disability; Vol. 37(3), pp.221–231.
CHANGING CONSEQUENCES
McKevitt, B. & Braaksma, A. (2008). Best Practices in Developing a Positive Behavior Support System at the School Level. NASP Publications. Best Practices in School Psychology V. McLaughlin, D. & Carr E.G. (2005). Quality of Rapport as a Setting Event for Problem Behavior: Assessment and Intervention. Journal of Positive Behavior Interventions; Vol. 7 (2); pp. 68–91.
FUNCTIONS OF BEHAVIOUR
Myers, R. Salbenblatt, J and Blackridge, M. Common “Problem” Behaviours and Speculations about Their Cause. Downloaded from http://dimagine.com/page66.html, March, 2014. Myers, R. (2010) Recognizing Psychosis in Persons with Intellectual Disabilities Who Do Not Use Speech. Psychiatric Times; December 2001, Vol. 18(12). Revised in December 2010.
TEACHING SKILLS
O’Brien, J. (1989). What’s worth working for? Leadership for Better Quality Human Services. Responsive Systems Associates. Parsons, M., Reid, D. & Lattimore, L.P. (2009). Increasing Independence of Adults With Autism in Community Activities: A Brief, Embedded Teaching Strategy. Behav Anal Pract; Vol. 2(2); pp. 40–48.
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Pitonyak, D, (2005). 10 Things You Can Do to Support a Person with Difficult Behaviours. Downloaded from http://dimagine.com/page5.html, March, 2014. Pokrzywinski J. & Powell, R. (2003). A Brief Review of Systems‐Level Issues in Behavior Support Plan Adherence. NADD Bulletin; Vol. 6 Article 2
GO FORWARD PLANNING
Reid, D., Rotholz, D. & Parsons, M. (2003). Training Human Service Supervisors in Aspects of PBS: Evaluation of a Statewide, Performance‐Based Program. Journal of Positive Behavior Interventions. Vol. 5 (1); pp. 35– 46 Rotholz, D. & Ford, M. (2003). Statewide System Change in Positive Behavior Support. Mental Retardation; Vol. 41(5); pp.354–364. Ryan, R. (1994a). Post‐traumatic stress disorder in persons with developmental disabilities. Community Mental Health Journal; Vol 30(1); pp. 45‐54.
MY DEVELOPMENT
KEY PERSON
RESOURCES
Ryan, R. & Sunada, K. (1997). Medical evaluation of persons with mental retardation referred for psychiatric assessment. General Hospital Psychiatry; Vol. 19(4); pp. 274‐280. Ryan, R.M. (1994b) Recognition of psychosis in persons who do not use spoken communication. In: Ancill, R.J., Holliday, S., Higenbottam, J. (eds.), Schizophrenia: Exploring the Spectrum of Psychosis. New York: Wiley Press.
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FOUNDATION
Sobsey, D. (1994) Violence and Abuse in the Lives of People with Disabilities: The End of Silent Acceptance? Baltimore: P.H. Brookes Publishing Co. Sturmey P. (1995) Functional Analysis in Clinical Psychology. John Wiley & Sons, Chichester. Sturmey, P. (2002). Mental retardation and concurrent psychiatric disorder: Assessment and treatment. Current Opinion in Psychiatry; Vol. 15, pp. 489 – 495. Watanabe, M. & Sturmey, P. (2003). The Effect of Choice‐Making Opportunities during Activity Schedules on Task Engagement of Adults with Autism. Journal of Autism and Developmental Disorders; Vol. 33(5); pp.535‐538.
CHANGING CONSEQUENCES
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KEY PERSON
RESOURCES
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COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
PROACTIVE NTERVENTIONS
Ryan, R.M., Sundheim S.T, Voeller, K.K.S. (1998) Medical diseases. Coffey, C.E., Brumback, R.A. (eds.) Textbook of Pediatric Neuropsychiatry. Washington, D.C.: American Psychiatric Press: pp. 1223‐1274.
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
Ryan, R.M. (2001) Handbook of Mental Health Care for Persons with Developmental Disabilities. Quebec: Diverse City Press Inc.
FOUNDATION
“Behave Away”: A maintenance plan – how to problem‐solve challenging behaviours while helping yourself cope. John Kosmopoulos MA, BCBA, MacKenzie Health
KIPBS Training. Kansas Institute for Positive Behaviour Support. http://www.kipbs.org/new_kipbs/fsi/modlinks.html#top
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
UNDERSTANDING BEHAVIOUR
Active Support Interventions and Their Effect on Increased Participation of Persons With Disabilities. University of Minnesota RTC on Community Living. http://rtc.umn.edu/rtc/index.php?topID=1 BILD Positive Behaviour Training. BILD, Birmingham. www.bild.org.uk
PROACTIVE NTERVENTIONS
POSITIVE BEHAVIOUR SUPPORTS
Curricula and Training Resources
Changing Behaviour: A comprehensive manual of applied behaviour analysis. C.A. Rubinco (Ed.) (2000), 2nd Edition, Toronto: Ontario, Ministry of Community and Social Services)
NADD COMPETENCY STANDARDS (e.g. # 1: Positive Behavior Support and Effective Environments.) The National Association of Developmental Disabilities Services www.thenadd.org Positive Practices in Behavioural Support Through Nonlinear Applied Behavior Analysis and Assessment and Analysis of Severe and Challenging Behavior. Dr Gary LaVigna, Clinical Director, Institute for Applied Behavior Analysis, Los Angeles. http://www.iaba.com/ Positive Behavior Support Training. Government of Western Australia Disability Services Commission. http://www.disability.wa.gov.au/ Positive Behavior Support Training Curriculum. Dennis H. Reid and Marsha B. Parsons. American Association on Intellectual and Developmental Disabilities http://aaidd.org/ Positive Behaviour Support – Getting it right from the start. Victorian Government Department of Human Services, Melbourne http://www.dhs.vic.gov.au Quality Behavioral Competencies Coach Training. David Lennox, PH.D, QBS Inc. https://www.qbscompanies.com/ (used for ‘Connecting the Dots: Toronto Region Developmental sector, September 2013) Resolving Behavioral Challenges Positively and Effectively. Meme Hieneman, Ph.D., BCBA. Positive Family Intervention Project; University of South Florida http://www1.usfsp.edu/coas/PFI/ Skill Builders – Using Positive‐based Behavioural Strategies to Teach Skills. Behaviour Management Services of York & Simcoe, York Central Hospital (now Centre for Behaviour Health Sciences, Mackenzie Health) Staff Training for Behavior Supports. David Sincoff M.A. Behavior Specialist; Athens County Board of Developmental Disabilities http://athenscbdd.org/ TIP: Training in Partnership. Developed by Toronto Network of Specialized Care to build capacity of supervisor/managers as leaders in dual diagnosis practice. Unlocking the Mysteries of Challenging Behaviours: A Training Manual for Staff working with People with Developmental Disabilities. Behaviour Management Services, York Central Hospital (now Centre for Behaviour Health Sciences, Mackenzie Health)
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FOUNDATION
THE PERSON:
Randy Age: 31 Diagnosis: Autism, Developmental Disability, Anxiety Disorder, Hyperactivity Target behaviour – aggression in the form of grabbing, scratching staff and peers’ arms, he can also bring another individual down to the ground after grabbing them.
The Person Directed Plan – Randy – Summary Points
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
CART KEY PERSON
CART Workbook for DSPs: Key Person
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FUNCTIONS OF BEHAVIOUR TEACHING SKILLS
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS GO FORWARD PLANNING RESOURCES MY DEVELOPMENT
KEY PERSON
My Relationships Family – 2 parents and sister Friends – my housemates Pastor at church Family physician My support staff My Life Now My home – I live with 17 other people in a house in the country My day program – attend 5 mornings a week (but not right now) My volunteer activities – none My paid services – none What’s Important to Me Past time activities – Watch TV with peers and support staff, visit with family 2x per month, out in community with peers – going out for coffee and to eat To soothe me – speak to me in a calm voice and assure me everything will be okay I enjoy – singing and dancing and music I don’t like – watching TV, dogs, loud noises and crowds For me to fulfill needs and wants – I am nonverbal but can say a few words – “mom”, “dad”, sister’s name and “hamburger” My Interests and Gifts Some great things about me – good singer, sense of humour and hearty laugh, nice smile Things I am good at – helpful in kitchen, playing drums, singing
CHANGING CONSEQUENCES
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
My Learning Things I am learning to do – make my bed, wash my hands, play harmonica, skate My Health and Well Being Healthy food choices that I enjoy and want included in my diet – veggies and dip, more apples, coffee, mashed potatoes Some of my favourite meals – hamburgers and fries, spaghetti with Alfredo sauce Meal prep – what wants to learn to prepare – coffee on own Activities for physical fitness – I like – swimming Other physical activities I’d like to do –learn to ice skate, ride a bike Day Services Likes about day program – greenhouse, arts and crafts, theme parties, music class Doesn’t like about day program – any activity that involves manual labour, too much noise and large group activities How to better support me at my day program – not too many demands at once What activities I would like added – things that include fine motor skills – more arts and crafts ‐ painting, work in the kitchen, playing different instruments My Life – Likes and Challenges What I would change about my life – being able to sleep when I want, play in a band, work that is not hard How to Listen to Me Things that do not work for me – being around dogs, lots of verbal instructions, too many people around me and busy places, doesn’t like TV Things that you can do instead – show me what you want me to do and be patient with me My Contributions and Dreams My personal qualities to appreciate and enhance – affectionate, helpful with routine tasks, playful, independent My dreams for life – less work, more time with family, a trip with my family back home, to ride a bike, to ice skate, play a lot of different instruments as well as be a better drummer
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MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
‐ A psychiatrist who specializes in the ‐ Randy is willing to learn new things and has been dual diagnosis can be accessed observed that he likes helping around the house (staff Data can be collected on biological currently do not like him to help clean/cook as they are factors (sleep, mood, bowel worried about germs/hygiene) movements etc.) ‐ Randy is active and can participate in sports
PROTECTIVE: Strengths that exist
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
‐ Parents are supportive and do advocate for what they think is best for Randy Randy visits parents every weekend in summer months and every other weekend in winter months
‐ Staff are very willing to give other residents attention when Randy ‐ Staff often want Randy to sit and watch TV (he does not like TV) When Randy is at home, his family is able to provide the 1:1 attention he wants
PROACTIVE NTERVENTIONS
‐ Relationships/rapport with staff and peers has not developed. There are no staff that are willing to work 1:1 with Randy Due to the high staff to resident ratio (8:1), there are few natural opportunities to teach Randy appropriate ways to gain attention
‐ The intensity of inappropriate attention seeking ‐ Lives in a group home setting behaviours increased since moving into residential living ‐ 18 peers live in residence ‐ Randy is primarily nonverbal, but can say a few words, ‐ Current staff to resident ratio is 6:1 “mom,” “dad,” “Vicky (sister)” and “hamburger”. ‐ Day program available on agency premises, ‐ It is difficult for staff to ignore or “not provide attention” to however placement is “on hold” due to Randy when he is aggressive due to its intensity. aggressive behaviour This is even more difficult for peers Other residents have expressed through language and behaviour towards Randy they do not want him around. Outings are organized and Randy is often not included
Randy’s parents do not want Residential staff to bring Randy to a psychiatrist who specializes in dual diagnosis. They would rather he continue to see their own family doctor even though he has expressed that he is becoming more challenged by Randy’s case and dual diagnosis is not his specialty
Randy’s parents do not like the residence giving Randy PRN medications, however, when Randy is in their care on weekends, they may give him up to 4 PRN per day
‐ Lived in Jamaica prior to receiving Autism Spectrum Disorder diagnosis ‐ Lived at home with both parents and an older sibling prior to moving to residential care
SOCIAL
Moved into residential living (away from close relationship ‐ School environment provided 1:1 support with parents) 12 years ago
‐ Skill deficit in coping with anxiety ‐ Skill deficit in appropriately gaining attention ‐ Skill deficit in appropriately in leisure skills
PSYCHOLOGICAL
PERPETUATING: Factors that sustain the problem – relationships/lack of services/ events
PRECIPITATING: Current causes – what is happening now that has triggered an event/issue
PREDISPOSING: Mental Health Diagnoses: Historical – from the ‐ Autism Spectrum Disorder, past, can be Anxiety disorder, Hyperactivity genetic/ upbringing/ Current Medications: political PRN Sleep: ‐ Does not sleep for whole night and often wakes in middle Irregular Bowell Movements: Low Thyroid, high blood pressure
BIOLOGICAL
FOUNDATION
BIOPSYCHOSOCIAL GRID
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
BIOP PSYCHOSOCIAL GRID: How to worrk with a B Biopsychossocial Grid d
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CART Workboook for DSPs: Key Person
CART Workbook for DSPs: Key Person
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Page 5
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
Randy grabbed and scratched all residents on his way down the hallway to kitchen.
During morning routines for other residents, all staff are busy. Randy in bedroom alone (as he does not go to day program, staff plan to get him up once the others have left for the day).
GO FORWARD PLANNING
Randy came into office and grabbed staff by left arm and dragged her to the kitchen.
While other residents were on an evening outing, 1 staff and Randy were in the house. Staff left Randy to complete paper work in office.
RESOURCES
Randy charged out of the bedroom to dining room. Randy grabbed female resident’s arms from behind and scratched her
Randy charged down hallway from living room to kitchen. Randy grabbed staff’s arms and pulled her to ground.
Staff set Randy up with a movie in living room. Staff went to kitchen to cook dinner. Other residents returned home from day program – lots of talking and laughing in kitchen.
Randy and a female resident were at home with one staff member (others were at day program). The other resident was upset and talking to staff at the dining room table
BEHAVIOUR
KEY PERSON
MY DEVELOPMENT
ANTECEDENT
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
Residents yelled, “don’t do that” “it hurts”. Staff came and sat with Randy until the others left.
Staff yelled, “what do you want?” and made him a snack and sat with him as he ate it.
Staff left the table and took Randy down the hall. Staff suggested Randy have a shower to “cool off.” Staff helped Randy with the shower routine.
Other residents screamed. Some left the area others stayed and watched. Another staff member yelled at Randy, “Why did you do that?” and escorted him to his room. This staff stayed near the doorway of Randy’s room for 10 minutes.
CONSEQUENCE
FOUNDATION
ABC CHART:
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MONTHLY SLEEP CHART (12 HOURS): Time 1 – Baseline / Initial
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CART Workbook for DSPs: Key Person
CART Workbook for DSPs: Key Person
Page 7
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MONTHLY SLEEP CHART (12 HOURS): Time 1 – Baseline / Initial
FOUNDATION
SLEEP CHART ANALYSIS:
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
INDIRECT MEASUREMENTS: QUESTIONS ABOUT BEHAVIOUR FUNCTION used not to determine function but to get staff to think about behaviour as serving a function used to guide functional analysis The Questions About Behaviour Function is an indirect measure designed for the functional assessment of behaviour problems in persons with developmental disabilities. Caretakers rate on a four point likert‐type scale for each item on a 25 item questionnaire. The instrument yields five categories reflecting the behavior functions of Attention, Escape, Physical, Tangible, and Nonsocial. The Questions About Behaviour Function is helpful in developing a hypothesis of the function of the target behaviour.
TEACHING SKILLS
Ranking 1 2 3 4 5
Ken Attention Sensory Tangible Escape Physical
Pat Attention Tangible Sensory Physical Escape
Dave Attention Sensory Tangible Escape Physical
Nancy Attention Tangible Physical Sensory Escape
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
look at sleep onset times (Randy’s is variable anywhere from 9PM‐1AM) look at wake up time (Randy’s is variable anywhere from 4AM‐9:30AM) look at how many hours of sleep per night (Randy – AVG 6 hours) look at frequency of interruptions ( 1‐2 per night) look at duration of interruptions (1/2hour – 2hours) Graph to see trends over time and effects of recommendations (e.g., sleep hygiene, structured evening routine, more activity during the day, use of natural remedies (Melatonin) or sleep medications)
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CART Workbook for DSPs: Key Person
FOUNDATION
RESOURCES
GO FORWARD PLANNING
Page 9
MY DEVELOPMENT
KEY PERSON
Therapist delivers work tasks (sweeping, cleaning the table etc.) and 3 step prompt hierarchy for incorrect responses and non‐compliance.
CART Workbook for DSPs: Key Person
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
a) Randy is delivered praise every 20 sec (and sing and drum with him) and has free access to preferred activities (music, drum). No demands are delivered by therapist. ‐ If target behaviour occurs therapist ignores briefly and then resume play/praise. ‐ If any form of inappropriate behaviour occurs, including the target behaviour, do not deliver attention. ‐ If behaviour occurs right as you were about to give attention/praise, wait another 5 seconds before delivering it. Demand: This condition is designed to determine whether the target behaviour is maintained by escape from task demands. The condition involves presenting a series of instructional trials to a person. Compliance produces praise, non‐compliance produces a series of prompts, and occurrence of the target behaviour immediately terminates the trial.
PROACTIVE NTERVENTIONS
a) Randy is informed that the therapist is busy. She sits near him in chair and does paperwork. She ignores him. ‐ If target behaviour occurs, therapist screams, says “stop that” or “why are you doing that” and then ignore him again. ‐ If any behaviours other than the target behaviour occur, ignore these also. b) Randy is informed that therapist is going to chat with a staff member and ignores him. ‐ If target behaviour occurs, therapist screams, says “stop that” or “why are you doing that” and then ignore him again while talking to staff member. ‐ If any behaviours other than the target behaviour occur, ignore these also. Control: This is designed to be a general control condition, in which no demands are placed on the person, continuous access to leisure materials is available, and attention is delivered frequently independent of the person’s behaviour.
CHANGING CONSEQUENCES
FUNCTIONS OF BEHAVIOUR
Attention: This condition is designed to determine whether the target behaviour is maintained by contingent attention delivered by a therapist. The condition involves remaining in a room with a person and ignoring all behaviour, except for the target behaviour, which is followed by attention.
TEACHING SKILLS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
DIRECT MEASUREMENTS: FUNCTIONAL ANALYSIS CONDITIONS:
FOUNDATION
Tangible: This condition is designed to determine whether the target behaviour is maintained by access to preferred items. Preferred items (foods, drinks, drums, ball, radio with favourite music) are held out of Randy’s reach (on shelf). If target behaviour occurs, the items are given to Randy briefly (20 sec or once consumed) then removed again.
RESULTS:
Functional Analysis ‐ Aggression March 2012 6
Frequency
5
Attentio n
4
Control
3 Demand
2 1
Tangible
0 1
2
3
4
19‐Mar‐12
5
6
7
8
9
27‐Mar‐12
10
Sessions
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
Prompt hierarchy: 1. verbal instruction to do task – provide brief praise if completed, if not move on the step 2. 2. verbal instruction plus demonstration of task – provide brief praise if completed, if not move on the step 3. 3. verbal instruction plus physical prompt to do task – do not provide any praise. If target behaviour occurs, task is removed and Randy is ignored for 30 sec (break) before resuming task. If other inappropriate behaviours occur (screaming, throwing things, Self‐Injurious Behaviours, etc.), continue with the sequence; do not terminate the trial when these responses occur.
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CART Workbook for DSPs: Key Person
CART Workbook for DSPs: Key Person
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UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES
FUNCTIONS OF BEHAVIOUR MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
Assessment indicates that Randy’s aggression is maintained by adult attention. Increased reinforcement reduces instances of behaviour as shown in in‐situ hypothesis tests.
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
SUMMARY:
TEACHING SKILLS
An in‐situ hypothesis test uses a design similar to that of a functional analysis. It is a quick switching of conditions. This test is conducted in the setting of interest and uses a functional treatment (based on the results of the Questions About Behaviour Function and most likely result from the functional analysis). The functional treatment is alternated with the baseline condition (no treatment implemented). For Randy, the hypothesized function is attention. Six days were used to complete the in‐situ hypothesis test. For three of the days, Randy was provided continuous attention from 9:00AM‐ 3:00PM and for three days; no treatment was implemented, though data was collected on behaviour. This assessment will be re‐run as Randy was sick during the last three days of the assessment. No Continuous Continuous Continuous No No Treatment Reinforcement Reinforcement Reinforcement Treatment Treatment April 10, April 11, 2012 April 12, 2012 April 13, 2012 April 14, April 15, 2012 2012 2012 2 1 0 0 2 0 Repeat of assessment: No No Continuous No Continuous Continuous Treatment Treatment Reinforcement Treatment Reinforcement Reinforcement April 28, April 29, April 30, 2012 May 1, May 2, 2012 May 3, 2012 2012 2012 2012 3 2 1 2 1 1 Total Behaviour during NO TREATMENT – 8 Total Behaviour during CONTINUOUS REINFORCEMENT – 4
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
IN‐SITU HYPOTHESIS TEST:
FOUNDATION FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
BEHAVIOUR SUPPORT PLAN: INTRODUCTION: Background Information: Randy is 31 years old. He moved to MARKHAM on Dec 31, 2004. Currently lives at the TORONTO HOUSE with 8 gentlemen and 10 women with at least 3 staff present at all times. Will and Cathy (parents) live in TORONTO with a sister (Vicky) and have regular weekend visits (every 1‐2 weeks). Medical Information: Diagnoses: Autism, hyperactivity, developmental delay, anxiety disorder and presents with aggressive behaviours. Medical diagnosis: Low Thyroid, high blood pressure Current Physicians: Dr. Wong (psychiatrist) is currently involved in the management of Randy’s challenging behaviour. Dr. Kormier is his family practitioner. Current Medications: (none; SDM will not support)
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
Communication Modality: ‐ speaks few words (mom, dad, hamburger, Vicky) ‐ will bring people to what he wants Need for Behavioural Support: ‐ uses aggressive behaviour to access attention from staff and peers ‐ placement at day program has been put “on hold” ‐ staff are not wanting to work with Randy ‐ peers are afraid of Randy
GOALS: 1. To have Randy learn an appropriate way to ask people to sit with him or do an activity with him 100% of the time. 2. To have Randy be able to spend time alone doing a preferred, leisure or functional activity for up to 10 minutes. 3. To have Randy return to day program at least 2 days a week. 4. To have Randy participate in more sports activities at least 2‐3 times a week. 5. To have consistency in terms of amount and quality of attention in all environments (parent’s home, residence and day program).
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CART Workbook for DSPs: Key Person
FOUNDATION
TARGET BEHAVIOURS TO INCREASE:
PROACTIVE NTERVENTIONS
gaining attention by using a picture card tolerance to being alone increasing time doing an activity
SUMMARY OF BIOPSYCHOSOCIAL ASSESSMENT:
CART Workbook for DSPs: Key Person
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TEACHING SKILLS
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS MY DEVELOPMENT
KEY PERSON
Function of Behaviour: Data on target behaviours were collected by staff at the TORONTO residence in the form of incident recording (e.g., ABC); incident reports, scatter plot and questionnaire and interviews (Questions about Behaviour Function, and FAST). Data were reviewed to identify frequency, intensity, duration and discrimination of target behaviour and to determine likely function(s). A Functional Analysis was conducted on two days during March 2012. Four different conditions were run all based on a hypothesized function of Attention, and Tangible (from Questions about Behaviour Function). Each condition was run for 10 minutes. Questions About Behaviour Function The Questions About Behavior Function is an indirect measure designed for the functional assessment of behaviour problems in persons with developmental disabilities. Caretakers rate on a four point likert‐type scale for each item on a 25 item questionnaire. The instrument yields five categories reflecting the behavior functions of Attention, Escape, Physical, Tangible, and Non‐social. The Questions About Behaviour Function is helpful in developing a hypothesis of the function of the target behaviour.
GO FORWARD PLANNING
FUNCTIONAL BEHAVIOUR ASSESSMENT:
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
See above (pages 3 and 4)
RESOURCES
POSITIVE BEHAVIOUR SUPPORTS
Aggression: In the form of grabbing and pinching others. This behaviour may result in bruises due to Randy digging fingers into flesh. He typically targets the upper arms and exposed skin. Females are targeted more than males. Before an aggressive attempt, Randy may watch someone and track their movements with his eyes or may begin to spit at individual.
UNDERSTANDING BEHAVIOUR
TARGET BEHAVIOUR TO DECREASE:
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES
Staff 1 Attention
Staff 2 Attention
Staff 3 Attention
Staff 4 Attention
2
Sensory
Tangible
Sensory
Tangible
3
Tangible
Sensory
Tangible
Physical
4
Escape
Physical
Escape
Sensory
5
Physical
Escape
Physical
Escape
Functional Analysis: Please refer to attached Functional Analysis Summary Attached (as above in this document). ABC Analysis: ABC Data suggest that target behaviours serve as an attention functions for Randy. Behaviour functions for Randy were identified in the order (most significant to least significant) that appears below. Frequency, Intensity, Duration, and Discrimination have also been designed based on ABC Analysis in the form of ABC Charts and Incident Reports.
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Results: Ranking 1
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CART Workbook for DSPs: Key Person
In the form of grabbing and pinching others. This behaviour may result in bruises due to Randy digging fingers into flesh. He typically targets the upper arms and exposed skin. He may also bring the person grabbed down to floor or bring in the direction he wants. Females are targeted more than males. Before an aggressive attempt, Randy may watch someone and track their movements with his eyes or may begin to spit at the person.
Frequency:
Grabbing 4x/month
Intensity:
Result in bruises due to Randy digging fingers into flesh.
Duration:
Grabbing 1‐3 minutes
Discrimination:
Females are targeted more than males. Occurs more often when at the residence
CART Workbook for DSPs: Key Person
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FOUNDATION
TEACHING SKILLS
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS GO FORWARD PLANNING RESOURCES
Situations where target behaviours are less likely to occur (i.e., low risk times) include: When engaged by staff (receiving praise, conversing, receiving attention, completing preferred activities) When involved in preferred activities (puzzles, playing drums, listening to gospel and reggae music, singing songs, eating snacks, going for van ride, watching TV, playing catch with/bouncing a basketball) When engaged in completing routine tasks (staff directed with short instructions e.g., “can you help me?”, “can you sweep the floor?”, “can you carry this for me?” Cooking (enjoys stirring food in pots) Attending music in the center, swimming, expressive arts During meal times Situations where target behaviours are more likely to occur (i.e. high risk times) include: When bored (lack of stimulating/structured activity) When staff attention is low or absent (staff in different area than him) When all staff are not consistent with their approach (following the Behaviour Support Plan) When Randy is feeling sick or ill When there is too much commotion in house When dogs are present When denied access to something he has requested without being offered an alternative
KEY PERSON
LOW RISK VS. HIGH RISK CONDITIONS:
MY DEVELOPMENT
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
Definition:
POSITIVE BEHAVIOUR SUPPORTS
Aggression
UNDERSTANDING BEHAVIOUR
PROACTIVE NTERVENTIONS
Frequency, Intensity, Duration, Discrimination Based on ABC Analysis:
FOUNDATION FUNCTIONS OF BEHAVIOUR
Access to preferred activities
Respecting personal space
Must receive regular positive interactions
Non‐preferred activities/items: Waiting – for an activity or requested item Being alone Absence of staff attention Loud environments Large crowds Sitting idly for too long Changes to routine/staff inconsistencies
MY DEVELOPMENT
KEY PERSON
RESOURCES
Staff must be trained to follow the NCR Protocol
Preferred Activities/Items: Music (reggae and gospel) Television – Randy will watch TV with staff if asked to do so, it is more about being with staff then actually watching what is on. Van rides – to pick up treats or look at scenery Walks – in backyard or at a trail Visiting his family Eating meals, snacks (apples, popcorn) Playing catch or bouncing a basketball with staff Puzzles (9pc or preschool level) Lying in bed Playing his drums Jumping on trampoline Going to church with his family Singing songs (his own tune) Assisting staff with cooking (stirring items), or routine chores Playing chase
TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS GO FORWARD PLANNING
Person’s Non‐Negotiable Access to music. Enjoys gospel and reggae Interaction provided consistently throughout the day following the Non‐ contingent Reinforcement Protocol
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
“NON‐NEGOTIABLE” CONDITIONS: Program Non‐Negotiable Gentle interactions with others Appropriate sexual behaviour
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CART Workbook for DSPs: Key Person
CART Workbook for DSPs: Key Person
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
Page 17
KEY PERSON
OBJECTIVES: 1. To have Randy learn an appropriate way to ask people to sit with him or do an activity with him 100% of the time. 2. To have Randy be able to spend time alone doing a preferred, leisure or functional activity for up to 10 minutes. 3. To have Randy return to day program at least 2 days a week. 4. To have Randy participate in more sports activities at least 2‐3 times a week. 5. To have consistency in terms of amount and quality of attention in all environments (parent’s home, residence and day program). PREVENTION (ANTECEDENT STRATEGIES): 1. Increase staffing ratio for Randy 2. Staff are to wear protective sleeves when working one‐on‐one with Randy, all other staff are to wear long sleeves and layers when working in the residence. Peers are encouraged to do the same. 3. Staff are to provide as much attention as possible – Randy does not like TV, this is not a good activity to set Randy up with. Actively try to find activities that Randy likes and that he can do by himself. If staff need to go to another area of the house, bring Randy with you and find something for him to do nearby. Chat with him every 2‐3 minutes. 4. Have Randy help staff with chores around house. He does not mind being given instructions ‐ “can you help me?”, “sweep the floor”, “carry this for me”. Randy also enjoys cooking (enjoys stirring food in pots). 5. Keep Randy active during the day to use up his energy – running/walking on trails or indoor track, swimming at rec centre. 6. Tell Randy when you cannot provide 1:1 attention. e.g., “I need to answer the phone; I’ll be back in 5 minutes.” Praise him when you return to room. e.g., “You did a great job waiting!” Be as quick as possible when you do need to leave him. 7. When staff need to divide their attention to other residents or household duties, set Randy up with a preferred activity. Praise him when you return to room. e.g., “You did a great job waiting!” NCR PROCEDURE: (A separate program, more detailed, has been written for this program) 1. Set the Timer to initial delivery schedule – currently at a 22 minute NCR interval 2. When the Timer goes off, deliver the reinforcer –attention such as drumming with him, providing music/games for him to engage in, bringing him preferred foods/drinks, going for walks (for at least 2 minutes) 3. If Randy engages in aggression during the interval, continue to provide the reinforcement on schedule. However, if aggression occurs right at the point the Timer goes off, wait 1 minute to provide reinforcement, to avoid reinforcing the aggressive behaviour.
MY DEVELOPMENT
POSITIVE BEHAVIOUR SUPPORT STRATEGIES:
FOUNDATION
Upon success, the schedule of reinforcement will be thinned meaning that the DRO interval will be progressively increased by 5‐10%. Apparatus required for intervention: Timer – to prompt mediator to provide the reinforcer when DRO interval elapses. Datasheets – Simple Frequency Data Kevlar – Sleeves and Gloves
SKILL BUILDING (REPLACEMENT BEHAVIOUR): Teach appropriate functionally equivalent replacement skill for undesired behaviour (e.g., asking for staff to sit with him or do an activity with him). Teach tolerance to being away from others – up to 10 minutes Use Assessment of Functional Living Skills to determine skills that staff can teach him – functional one‐on‐one time Teach leisure skills – increase the amount of time he spends on known activities and find new activities that interest Randy. INTERVENTION STRATEGIES (TO USE ONCE PROBLEM BEHAVIOUR HAS OCCURRED): Avoid giving the problem behaviour high quality attention. Try to act as neutral as possible. Redirect Randy to his room or an area away from others with minimal attention (keep language at a minimum. Use gestures and avoid eye contact) See Crisis plan Reminder: When Randy is using appropriate behaviours provide him with high quality, 1:1 attention PRN PROTOCOL With psychiatrist signature (attached)
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
4. In addressing Randy’s aggression use a neutral voice, direct him to another area away from peers, and try not to provide him with additional reinforcement when there is behaviour.
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CART Workbook for DSPs: Key Person
CART Workbook for DSPs: Key Person
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FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES
FUNCTIONS OF BEHAVIOUR TEACHING SKILLS
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS GO FORWARD PLANNING MY DEVELOPMENT
KEY PERSON
RESOURCES
FADING AND ELIMINATION OF INTRUSIVE BEHAVIOUR INTERVENTION STRATEGIES The purpose of the individual’s Behaviour Support Plan and the Person Directed Plan is to focus on preventative and proactive interventions and incorporates a positive behaviour approach to guide staff to safely and effectively manage challenging behaviour with the outcome of successfully eliminating all intrusive behaviour interventions such as mechanical restraints, PRN dispensation and social isolation. Recommendations for fading or eliminating intrusive behaviour interventions are: Positive Behaviours Strategies listed should be tried and exhausted before any intrusive measure is used. The administering of a PRN is considered intrusive behavior strategies, and should be deemed as a last resort. If through successful redirection to preferred activities and ensuring that choices are provided and support is given towards goals we can eliminate his PRN. If a PRN has not been administered for 6 months we will refer to his consulting psychiatrist to have his PRN discontinued. Continue to have Randy and his family involved with development with his Person Directed Plan. Support Randy with all goals while providing choices and education on subjects of interest. Comply with all aspects of Randy’s NCR Protocol Communication between staff and new hirers, also include family. DOCUMENTATION: Document all occurrences of problem behaviour as it happens or by the end of each shift. Behaviour data are reviewed on an on‐going basis for program evaluation and revisions to this Support Plan will be made as required. The following is a list of all documents that must be completed for Randy. o ABC Charts o Incident Reports if applicable o Hygiene Charts o Interval Tracking/data collection NCR Data Collection; which includes Bristol stool chart, food log, and access to tangibles
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
IMPLEMENTATION AND MONITORING: All designated TORONTO HOUSE support staff are required to review contents of this Behaviour Support Plan as it becomes available during initial implementation, if revised, or during annual review on SOP. Managers will ensure that all support staff have reviewed by means of monitoring staff activities via SOP (Read/Unread document feature). Supervisors or designate will provide training, and feedback (7 step feedback protocol) to support staff to facilitate the consistent implementation of any strategies outlined within this document. Ongoing behaviour data will be collected by support staff in the form of ABC data collection and or Incident reports. Treatment adherence conducted and data collected by Supervisors to ensure that Behaviour Support Plan is being followed as written and to evaluate its effectiveness with dealing target behaviours, skills acquisitions and Consequence strategies with the goal of fading intrusive measures. The following individuals have agreed to the information, intervention and recommendations contained within this document with the exception of intrusive measures, which can only be approved by the consulting Psychiatrist, Psychologist, Psychological Associate, Physician or a Behaviour Analyst certified by the Behaviour Analyst Certification Board (Regulation 299/10, 18(3)(e)). Signatures: Author Individual or Substitute Decision Maker Supervisor Certified Behaviour Analyst
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CART Workbook for DSPs: Key Person
CART Workbook for DSPs: Key Person
KEY PERSON
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MY DEVELOPMENT
GO FORWARD PLANNING
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
Directive: Take control of an escalating situation by setting limits. Staff offers clear expectations. Offer available activities. Avoid power struggles. Verbally redirect to quieter area in a calm yet firm manner. Clear audience from area, if not possible, direct Randy to a secluded area (bedroom, outside
Defensive: The beginning stage of loss of rationality. Intensity increasing to faster more forceful pacing and running placing hands on wall once he has reached one end of hallway and projecting himself off wall and running to other wall. Restlessness (cannot sit / lie down or focus on a task).In and out of bedroom, will not engage in any preferred activity Refuses to follow verbal direction will not comply with any request (covering his ears with loud vocalization)
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Supportive: An empathic, non-judgemental approach. Ask what he wants? Ask RW to show you. Offer available activities such as music, drums, sports. Please ensure staff engage Randy during redirection to activity and quiet area. Verbally redirect Randy to a calming area to divert attention (e.g., downstairs, outside for a walk at the back of house, rocking chair in back or alternative when on family visit etc.) in a calm yet firm manner. Give clear answers to his questions, answer him. Comply with reasonable requests Be prepared to evacuate peers.
Anxiety: A noticeable change or increase in behaviour. Excessive pacing/running back and forth in hallway Crying loudly, loud vocalizations, this will increase in intensity. And duration. Repeated requests for items or wants after he has received the answer or item such as Van rides, hamburger etc.
RESOURCES
Mediator’s Approach to Behaviour
Randy’s Behaviour
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
POSITIVE BEHAVIOUR SUPPORTS
lower demands with reinforcement to regain rapport
Therapeutic Rapport: An approach used to re-establish communication.
Tension Reduction: Decrease in physical and emotional energy. Randy quieter, content with activity and surroundings. Happy, laughing Apologetic to staff “Buddy” Complies with requests
UNDERSTANDING BEHAVIOUR
Nonviolent Physical Crisis Intervention: Continue with redirection in a calm yet firm manner – limit verbal instructions Clear audience from area, if not direct Randy to a secluded area where he can be monitored safely(bedroom/outside) If Randy is causing harm to himself or others please utilise your CPI training geared towards this particular situation. Always make sure you are in CPI stance and that if back up is needed and alone contact on call Manager and please refer to personal alarm memo in regards to direct alert.
Acting-Out: The total loss of rational control. Grabbing/pinching staff or peers usually on fleshy under part of arm. Spitting
FOUNDATION
CRISIS PLAN:
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
ADHERENCE CHECKLIST:
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CART Workbook for DSPs: Key Person
CART Workbook for DSPs: Key Person
MY DEVELOPMENT
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KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
BASELINE AND TREATMENT DATA:
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CART Workbook for DSPs: Key Person
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
MY DEVELOPMENT
UNDERSTANDING BEHAVIOUR
Direct Support Professional Knowledge and Skills Self-Assessment MODULE 1: Positive Behaviour Supports
PROACTIVE NTERVENTIONS
Knowledge Areas (Put ‘S’ for key strengths and ‘D’ for development)
The Positive Behaviour Support approach
The ways in which biologically‐based issues affect behaviour
The common medical or health issues that often go undetected for people with developmental disabilities
The factors that need to be considered in the 'bio', 'psycho', and 'social' domains of the Biopsychosocial approach
The distinction between historical, contributing, and sustaining factors in the Biopsychosocial formulation The purpose of a Functional Behaviour Assessment (FBA) and when it is needed
CART Workbook for DSPs: My Development
Page 1
MY DEVELOPMENT
KEY PERSON
RESOURCES
FUNCTIONS OF BEHAVIOUR
The purpose of a Biopsychosocial framework in understanding people and their needs
The relationship between Person Directed Planning and Positive Behaviour Support
TEACHING SKILLS
How Positive Behaviour Support enhances quality of life for individuals
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
The difference between proactive and reactive positive support interventions
GO FORWARD PLANNING
CHANGING CONSEQUENCES
FOUNDATION PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
Skill Areas (Put ‘S’ for key strengths and ‘D’ for development)
CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR
I identify and use self‐care strategies to ensure that I can be an effective supporter I observe the people I support with an eye to understanding how I could adjust support strategies
I challenge practices within the environment which are inconsistent with a Positive Behaviour Support approach
I devote time and energy to creating an environment that reduces challenging behaviour in the people I support
I consistently make it a priority to spend time with the people I support I seek out information and ‘dig deeper’ to understand needs and underlying issues of those I support I make time to understand what is important to increasing quality of life for the people I support I explore underlying issues (dental, medical, mental health) that could be causing problem behaviours I collect information to complete a Biopsychosocial formulation grid for the people I support I use self‐reflection to monitor how my behaviour is affecting the people I support
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
As part of my usual practice, I consider and include choices and preferences of the people I support
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CART Workbook for DSPs: My Development
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
MODULE 2: Understanding Behaviour
What ‘frequency’ of behaviour means
What ‘intensity’ of behaviour means
What ‘duration’ of behaviour means
What ‘discrimination’ of behaviour means
Why it is important not to make assumptions about behaviour
Why it is important to be aware of biases when observing and seeking to understand behaviour
The difference between setting events and antecedents
Why it is important to understand the context of behaviour
What the A, B, and C stand for in ABC
Skill Areas (Put ‘S’ for key strengths and ‘D’ for development)
I develop accurate operational definitions of behaviours I observe I identify my beliefs and biases about behaviours I observe I observe behaviour and identify setting events and antecedents I observe behaviour and identify the consequences.
CART Workbook for DSPs: My Development
Page 3
MY DEVELOPMENT
KEY PERSON
RESOURCES
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
I describe behaviour in an objective, observable way
GO FORWARD PLANNING
PROACTIVE NTERVENTIONS
The core function of the Direct Support Professional in collecting accurate data
CHANGING CONSEQUENCES
FUNCTIONS OF BEHAVIOUR
The importance of describing behaviour in observable, measurable terms
TEACHING SKILLS
UNDERSTANDING BEHAVIOUR
Knowledge Areas (Put ‘S’ for key strengths and ‘D’ for development)
FOUNDATION
What an antecedent is
Actions a Direct Support Professional can take to alter antecedents to prevent challenging behaviour
What a setting event is
What a reinforcing event is
How reinforcement of inappropriate behaviour can create problems for people and those who support them
Ways to prevent problems through skill teaching and environmental changes
How proactive interventions prevent escalation of challenging behaviour
How reactive strategies prevent escalation of problem behaviour
Environmental variables that impact support and behaviour
Specific ways to prevent problems through skill teaching and environmental changes
The impact and role of my own behaviour in setting and antecedent events
How to listen actively, respond effectively, and encourage communication
Alternative communication approaches for people who are non‐verbal
Strategies to offer choices to people at different functioning levels
Skill Areas (Put ‘S’ for key strengths and ‘D’ for development)
I design antecedent interventions tailored to a person’s unique social, environmental, or cultural setting
I adapt the environment to enhance quality of life and reduce problem behaviours
I identify and utilize preferred activities and items to increase positive behaviour
I listen actively to others, identifying emotional messages and using paraphrasing to check for understanding
I use a range of strategies to enhance communications and build rapport with the people I support
I change my communication style and use specific tools and strategies to communicate with people with different capabilities
I select appropriate choice‐making strategies for people with different capabilities
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
CHANGING CONSEQUENCES
Knowledge Areas (Put ‘S’ for key strengths and ‘D’ for development)
FUNCTIONS OF BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
MODULE 3: Proactive Interventions
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CART Workbook for DSPs: My Development
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
MODULE 4: Changing Consequences Knowledge Areas (Put ‘S’ for key strengths and ‘D’ for development) Positive reinforcement of behaviour
Negative reinforcement of behaviour
Consequences of behaviour
Punishment as it relates to behaviour
The risks of, and ethical issues related to, punishment
The relationship between a preference assessment and determination of what will actually reinforce behaviour
How to conduct a preference assessment
How positive and negative reinforcement change behaviour
The principles of effective reinforcement
Ways of delivering reinforcement and when to use them
The benefits of positive reinforcement
I use information about the person’s preferences and what is meaningful to them to determine how to reinforce behaviour
I use specific techniques to determine what is reinforcing for the people I support
I use strategies to avoid escalation of problem behaviours
I change my behaviour to increase appropriate behaviours of the people I support
I use reinforcement to enhance rapport with the people I support
I describe how reinforcement (intended or inadvertent) can change behaviour
I identify preferred things or potential reinforcers for the people I support
I change consequences to increase desirable behaviour of the people I support
I change the way I respond/react to prevent accidentally reinforcing problem behaviour
I describe the difference between positive and negative reinforcement
RESOURCES KEY PERSON
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MY DEVELOPMENT
CART Workbook for DSPs: My Development
I ask questions and use observation to find out what is reinforcing to the people I support
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Skill Areas (Put ‘S’ for key strengths and ‘D’ for development)
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR
MODULE 5: Functions of Behaviour Knowledge Areas (Put ‘S’ for key strengths and ‘D’ for development) The core functions of behaviour
Why it is important to not make assumptions about the function of behaviour Data collection and functional assessment tools used to collect data and monitor behaviour How to complete an ABC chart in preparation for a Functional Behaviour Assessment
What I need to contribute to a Functional Behaviour Assessment
I recognize how understanding the functions of behaviour is a prerequisite for behaviour change
Skill Areas (Put ‘S’ for key strengths and ‘D’ for development)
I ask questions to better understand the functions of behaviour
I observe the behaviour of the people I support so I can contribute to a functional assessment and behaviour support planning
I collect data / gather information to provide input to Behaviour Support Plans and/ or Functional Behaviour Assessments
I use data collection sheets to track the frequency of behaviours
I can give examples of the four main functions of behaviour
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
The risks of not collecting accurate information or data to establish function
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CART Workbook for DSPs: My Development
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS
MODULE 6: Teaching Skills
Completing a task analysis
Taking a baseline for a task analysis
The impact of skill deficits on behaviour
The definition and importance of generalization in building skills
Choosing functional skills to teach that are socially significant
Chaining as a teaching tool
The priority skills to teach to increase independence of people
Modeling as a core teaching strategy
The Premack Principle
How to use prompting to teach skills
Elements of a teaching plan
Reinforcement, generalization, and thinning techniques
PROACTIVE NTERVENTIONS
The components of a task analysis
I find opportunities to teach skills during daily routines
I use modeling to show people what it is I want them to do
I use prompting to help people build, practice, and use skills
I match prompts to the person’s skill level
I use clear, concise, and descriptive phrases to deliver instructions
I notice and reinforce any occurrences of generalization
I teach people skills (coping skills, social skills, functional skills, communication skills) to increase independence
I use a task analysis to break down a complex behaviour into smaller steps
I prepare multi‐step skill teaching plans
I implement teaching plans and monitor skill acquisition
I develop and implement maintenance and generalization strategies to sustain skills
CART Workbook for DSPs: My Development
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
GO FORWARD PLANNING
I teach people adaptive skills that enhance independence
RESOURCES
KEY PERSON
I teach effective, alternative skills to manage problem behaviours
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MY DEVELOPMENT
TEACHING SKILLS
Skill Areas (Put ‘S’ for key strengths and ‘D’ for development)
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
UNDERSTANDING BEHAVIOUR
Knowledge Areas (Put ‘S’ for key strengths and ‘D’ for development)
FOUNDATION POSITIVE BEHAVIOUR SUPPORTS UNDERSTANDING BEHAVIOUR PROACTIVE NTERVENTIONS CHANGING CONSEQUENCES FUNCTIONS OF BEHAVIOUR TEACHING SKILLS COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
Knowledge Areas (Put ‘S’ for key strengths and ‘D’ for development)
The importance of integrating the Person Directed Plan with the Behaviour Support Plan
The components of a Behaviour Support Plan
The goals of a Behaviour Support Plan
The reasons that a Behaviour Support Plan must be implemented as written without alteration
A Direct Support Professional’s contribution to the development of a Behaviour Support Plan
Collecting and using behavioural data to determine if a Behaviour Support Plan is working
Identifying barriers to the implementation of a Behaviour Support Plan and how to overcome them
When to ask for help during implementation of a Behaviour Support Plan
The purpose of debriefing
Skill Areas (Put ‘S’ for key strengths and ‘D’ for development)
I contribute to behaviour support planning by suggesting realistic and doable strategies for the people I support
I reflect on the Behaviour Support Plan strategies I use in order to determine their effectiveness
I ask questions to clarify and ensure understanding with regard to the Behaviour Support Plans for the people I support
I work collaboratively with other staff to assist in carrying out Behaviour Support Plans consistently
I identify situations where additional expertise is needed to carry out a Behaviour Support Plan effectively and take action/ask for help
I reflect on my own role and behaviour in incidents in the support environment and contribute to debriefing discussions to improve support to people
I reflect on debriefing processes to help me improve the way I support people
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
MODULE 7: Collaborating to Address Challenging Behaviours
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CART Workbook for DSPs: My Development
KEY PERSON
RESOURCES
CART Workbook for DSPs: My Development GO FORWARD PLANNING
Completion Date
2
3
4
5
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ACTION PLAN CHANGING CONSEQUENCES
1
FUNCTIONS OF BEHAVIOUR
Resources or Supports
TEACHING SKILLS
Actions
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
Goal: Outcome: Measures of Success:
MY DEVELOPMENT
POSITIVE BEHAVIOUR SUPPORTS
FOUNDATION
My Development Plan GOAL #1
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
GOAL #2
Goal: Outcome: Measures of Success:
ACTION PLAN
Actions
Page 10 Resources or Supports Completion Date
1
2
3
4
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CART Workbook for DSPs: My Development
FOUNDATION
KEY PERSON
RESOURCES
GO FORWARD PLANNING
CART Workbook for DSPs: My Development
2
3
4
5
Completion Date
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PROACTIVE NTERVENTIONS
ACTION PLAN
CHANGING CONSEQUENCES
Resources or Supports
FUNCTIONS OF BEHAVIOUR
Actions
TEACHING SKILLS
1
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
Goal: Outcome: Measures of Success:
MY DEVELOPMENT
FOUNDATION
GOAL #3
Areas for Development
My Strengths
KNOWLEDGE I want to learn more about this
SKILL I want to learn how to do this
FOUNDATION TEACHING SKILLS
FUNCTIONS OF BEHAVIOUR
CHANGING CONSEQUENCES
PROACTIVE NTERVENTIONS
UNDERSTANDING BEHAVIOUR
POSITIVE BEHAVIOUR SUPPORTS
Worksheet | Planning for Developmental Goal Setting
RESILIENCY SKILL I want to learn how to do this
MY DEVELOPMENT
KEY PERSON
RESOURCES
GO FORWARD PLANNING
COLLABORATING TO ADDRESS CHALLENGING BEHAVIOURS
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CART Workbook for DSPs: My Development