Effects of the Behaviour Education Program

The Behaviour Education Program (BEP; Crone et al 2004) is a modified check in, check out program for students who may not respond to school wide behaviour plans. The groups of students who may benefit from this type of secondary intervention are those with:
a. poor peer relations
b. low academic outcomes
c. chaotic home environments

These type of students may require more practice in behavioural expectations as well as academic modificitions to ensure success.

The daily check in, check out program provides these students with positive adult interaction as well as targeting these students for other secondary interventions that may aid in decreasing future inappropriate behaviour.

The study was conducted in the following manner:

Students were selected for participation in the study if they (a) entered the BEP intervention after at least 2 months of school (to establish a baseline office discipline referral rate), (b) received the BEP intervention for at least 6 weeks, (c) had received at least two office discipline referrals, and (d) were nominated by instructional staff to receive additional behavior support. Students selected for the study also had to demonstrate problem behavior throughout the school day rather than during one academic period (i.e., math, language arts) or only during unstructured times (i.e., recess or lunch). Of the 17 students who received the BEP intervention during the school year, only 13 met the criteria to be included in the study, with parental permission being secured for 12 students. The 4 students who were excluded from the study were already receiving the support of the BEP at the beginning of the school year; thus, a baseline measure of the dependent
variable could not be established. Of the 12 students included in the study, 10 were boys and 2 were girls,with 2 from ethnic minority backgrounds. Eight of these 12 students qualified for free or reduced lunch. One of the 12 students in the study was receiving special education services for a learning disability in reading.
Students engaged in a range of problem behaviors, including talking out; making inappropriate comments; failing to complete work; and failing to keep hands, feet,
and objects to self (e.g., playing with another student’s hair, throwing paper). None of the students in the study engaged in severe problem behavior, such as physical aggression, property destruction, or self-injurious behavior.

Implementation of the Behaviour Program

Once parental and student permission was obtained for a student, the BEP was implemented. The BEP process involved the following five elements: First, students were required to “check in” with a paraprofessional before school.
The paraprofessional provided the student with a Daily Progress Report (DPR) form that was carried to class for feedback throughout the day. When students checked in, they were asked if they had their DPR from the day before signed by their parents and if they had their materials ready for the school day. They received praise and a lottery ticket for a weekly drawing for checking in. Also during check in, students were prompted to identify daily goals and given feedback to encourage success. For some of the younger students, the paraprofessional delivered the DPR to their classrooms.

Second, during natural transitions in the school day (i.e., after language arts, after math), teachers would provide students with feedback on their DPRs. Teachers provided feedback on student behavior at the end of each time period by rating either 0 (did not meet expectations), 1 (somewhat met expectations), or 2 (met expectations). The expectations for all students were the same as the schoolwide
expectations: (a) keep hands, feet, and objects to self; b) use kind words and actions; (c) follow directions; and (d) work in class. Teachers also provided immediate verbal praise for students who met behavioral expectations for that time period and corrective feedback if students did not meet the expectations.

Third, at the end of the school day, students took the DPR to the paraprofessional to check out. Student percentage of points for the day was calculated, and students received praise and rewards if they met their daily point goal. Rewards were randomly selected each day using a spinner system and included small pieces of candy, schoolwide tokens, or a bonus move on a sticker chart system. Daily point goals were developed during a meeting among the BEP coordinator, teacher, and student before the student was placed in the BEP. For all students in this study,
80% of the total points earned (i.e., 40 out of 50 total points) was their daily point goal. If students did not meet their daily goal, the paraprofessional would provide information on what to work on for the following school day.

Fourth, students then took their DPR home to be signed by a parent/guardian, and fifth, the Daily Progress Report was signed by a parent and returned the next morning. Student data on the BEP were summarized daily, and the schoolwide behavior support team met bimonthly to examine student progress on the intervention. Students were considered to be making progress on the BEP if they were receiving 80% or more of their possible points each day.

OUTCOMES

Although more research is needed to further document the effectiveness of the BEP, the data from this study as well from previous research encourage the addition of this type of intervention to a school’s system of behavior support.
The BEP can be modified by incorporating functional assessment procedures, and this modification may lead to the BEP being effective with more students (Crone et al.,
2004). For example, for students who are motivated by peer attention, the BEP can be modified to allow students to earn reinforcers to share with their peers (e.g., free gym time, extra recess for the class). For students who are engaging in problem behavior to escape from math that is too difficult, the BEP could be combined with academic supports to improve the student’s math and organization skills. To strengthen the research base for the BEP, future studies should investigate the effectiveness of including functional assessment procedures for students who are not
responding to the basic BEP intervention.

Hawken, L.,Macloed,S.,& Rawlings, L(2007); Effects of the Behavior Education Program
(BEP) on Office Discipline Referrals of Elementary School Students; Journal of Positive Behaviour Interventions, 9(2), 94-101

The ASD Nest Program

Lord and McGee (2001) believe that education is still the primary form of treatment for children with ASD, parents and teachers. The classroom has the potential to impact the lives of children with ASD. The ASD Nest Program was developed to help higher functioning ASD children learn how to socially and academically function in school and their community.
The idea of the "nest" provides the children with supportive structure in a nurturing environment. The Nest Program typically starts in kindergarten and moves the children throuhg the grade levels. The Nest Program utilizes the required support systems for the child to function successfully. Teams are set up within the classroom to meet the complex needs of the child. Strategies are then employed by the therapists and teachers to modify the enviroment so the child can excel within the classroom. The strategies are research based and consist of positive behaviour support and social stories, relationship based strategies and other social cognitive strategies.
Basic instructional supports include:
* Daily class schedule
* Visual aids
* Choice making opportunities
* Role playing
* Classroom environmental modifications
* "Catch them being good"

The Key Elements of the Program:

1. Class Size:
2. Co-teaching model:
3. Targeted Goal Areas:
4. Social Developmental Curriculum:
5. Home School Connection:
6. Specialized preservice training:
7. Teaming:
8. Ongoing site support:
9. Additional Learning Opportunities: Peer Supports

Organization of the Classroom Environment: (Children with ASD have difficulty with sensory processing and can become overloaded. Ensure classroom is not overwhelming)

* Display only those materials that are being used in a lesson or that are needed for ongoing reference. Put them out of sight when they are no longer useful.

* Use drop cloths to cover shelves holding play items that may be distracting when they are not being used.

* Reserve on particular bulletin board or area of the room to display children's work and only display items that are relevant to current learning.

* Be mindful of the child's visual point of view. Children should be able to easily view relevant material.

* Clearly mark areas used for group and individual work, including learning centers.

* Set a quiet area with a bean bag chair and tools for self calming such as headphones for listening and manipulatives.

* Avoid the clutter that may be created by unnecessary furniture and materials or poorly organized materials.

SOCIAL DEVELOPMENT INTERVENTION

1. Experience Sharing: Promote engagement and interaction: Build a "we-fort" Assign roles that together are needed to complete the structure, thereby encouraging communication. Creating a shared memory.

2. Language Comprehension: Become aware of pragmatic language weaknesses as well as the use of educator language. "Person of the Week" (Winner, 2005). Tell the children to find out as much as they can about a peer. Collect information througout the week and put it on a tree or friendship file. Encourage questioning techniques and information gathering.

3. Problem Solving: Promote flexibility in problem solving both in the academic and social domains.

4. Social Cognition or Social Thinking: Encourage social thinking through the use of vocabulary and model situations that require us to think about others. "Social Detective Agency" Students study photograph, illustrations from familiar literature and movie clips collecting clues to make "smart guesses" as to what the character may be thinking, feeling and planning. Have studens look at non verbal clues in order to assess a situation.

5. Flexibility/Self Regulation: Model flexible thinking and encourage the use of flexible vocabulary. "Identify Your Team of Unthinkables" Help the children identify their unthinkables, the characters that get in the way of being good social thinkers. The Unthinkables are enemies of Superflex, or Rockbrain that we can defeat if we train ourselves to recognize when we are being inflexible.

6. Incorporating Strengths and Preferred Interests: Capitalize on preferred interests to help with the student's thinking.

As the authors of this article state there can be many barriers to implementing a best practice program. Funding, inappropriate staff, and a lack of dedicaiton or motivation to find news ways to help children with ASD. The Nest Program tiries to address these issues as a team and is supportive of everyone involved. Maybe worth looking at!!

Bleiweiss, J., Brennan, S., Cohen, S., Koenig, K., & Siegel, D.,(2009); A model for inclusive public education for students with autism spectrum disorders. The ASD Nest Program. Teaching Exceptional Children, 6-13

Auditory Prompting Systems to Reduce Problem Behaviour

Results of this study confirm self-operated auditory prompting systems to be a socially valid function-based intervention for use in public community settings with
students with moderate mental retardation who have attention- or escape-maintained behavior when the prompts provide functionally equivalent reinforcement. This study
expands the literature on self-operated auditory prompting systems by matching the prompts to the function of problem behavior and confirming the social validity of the
intervention by including nondisabled coworkers.

Although previous studies (Alberto et al., 1999; Davis et al., 1992) documented that self-operated auditory prompts were an effective intervention for the reduction of
problem behavior in public community settings for students with moderate mental retardation, the function of behavior was not determined prior to intervention. It was unclear if the prompts inadvertently achieved functional equivalence or if stimuli other than the prompts were responsible for the behavioral change. Results of this study suggest that self-operated prompts function as an effective behavior intervention for students with mental retardation and attention- or escape-maintained behavior by systematically introducing prompts that provide functionally
equivalent reinforcement. Attention-maintained behavior reduced to criterion only during conditions with prompts providing attention in the form of verbal praise. Escape maintained behavior reduced to criterion only during conditions with prompts providing reminders of escape in the form of a break from the task. Problem behaviors were reduced for escape-maintained behavior during the attention prompt condition, but behavior only reduced to criterion during escape prompts.

Alberto P, Frederick L, & Hughes M (2006). Self operated auditory prompting systems as a function based intervention in public settings. Journal of Positive Behavioural Interventions. 8(4)230-243.

Auditory Prompting
Taber et al., (1999) provide a notable example of using auditory prompts to decrease off-task behavior for a student with autism and moderate mental retardation. Using a multiple probe across settings design, a 12-year old male student with autism was taught to use a self-operated auditory prompting system. The system contained recorded music interspersed between auditory verbal prompts (e.g., "keep working," "pay attention," etc.). The result was a decrease in inappropriate and off-task behavior at home and school with a concurrent decrease in teacher-delivered prompts.

A more recent study used auditory prompts to cue in-class self-monitoring as an intervention for decreasing off-task behavior in a classroom setting (Coyle & Cole, 2004). For three children with autism (aged between 9 and 11), an auditory timer (available from Jadco[R] was used to prompt self-monitoring of on-task behavior every 30 s of a 5 min work interval, with interval time increasing to 1 min for 1 of the participants. Using reversal designs, researchers were able to show that off-task behavior was significantly decreased during intervention phases.

Auditory prompting devices often require less manpower to result in positive change which is a critical benefit given the increasing number of children with autism served in local school settings where teacher resources may be scarce. Modern auditory prompts such as auditory pagers, portable compact disc players, and MP3 players are relatively small and unobtrusive and are used by enough children to minimize any stigma associated with carrying one for therapeutic purposes. Despite these apparent benefits, the paucity of literature focusing on technology-based auditory prompting for children with autism makes generalization of current findings difficult. Future research, as suggested by Taber et al. (1999), should continue to examine the effectiveness of self-operated auditory prompting systems with this population. Although Taber et al. (1999) & Coyle and Cole (2004) focused on decreasing off-task behavior, future investigations should also evaluate the effectiveness of auditory prompting for skill acquisition.

Goldsmith T, & Leblanc L(2004). Use of technology in intervention with children with autism. Journal of Early and Intensive Behavioural Intervention.

Contingency Mapping

Contingency mapping is a new type of visual support strategy that has not been reported in the research literature to date (Brown, 2004). Contingency maps are graphic (i.e., pictorial) representations of the environment–behavior relationships inherent in PBS plans that involve FET. The aim of a contingency map is to make a behavior support plan more transparent by graphically depicting both the current and the alternative antecedent–behavior–consequence pathways related to the problem behavior. As such, contingency maps must represent all of—and the relationships between—the following components: (a) the common antecedent that precedes both the problem and the replacement behavior, (b) the topography of both the
problem and alternative behavior, (c) the functional reinforcer that will be provided contingent on alternative behavior, and (d) the previously available functional reinforcer that will no longer be provided contingent on problem behavior.

Brown, K. & Mirenda, P (2006). Contingency mapping: Use of a novel visual strategy as an adjunct to functional equivalence training. Journal of Positive Behaviour Interventions,
8 (3).

Classroom Strategies for FASD

Classroom Strategies (this list is a start)

Work with student’s developmental age not his chronological age

• Repeat, repeat, repeat. Repeat, re-teach, repeat, reteach. Adapt the curriculum expectations
• If she repeatedly has outbursts look for the inciting stimuli and steer her away from them
• Alternate times of calm with activity, mini breaks for “brain gym” activities could be helpful
• Reduce stimuli in classroom. Have him looking at a blank wall up near you, not a colourful display
• Use a ruler, paper to cover everything except what is being read at that moment
• Colourful, attractive displays are very, very distracting for children with fasd. Low stimulus works
• Be prepared to handle clothes that itch (distract) — turn t-shirt inside out and tell parent/caregiver
• Figure out what she is good at and build on these functional skills
• Hands-on learning
• Small class size if possible
• Minimize transitions and prepare him for them in advance, “we are going to get out the red book”
• Transitions — forewarn, auditory cue (same song), visual cue (coat), action cue (hold coat open)
• Laminated visual cues — eg. coat, bathroom sink, lunch are helpful — visual learners
• Easy read labels — symbols, be organized, aim for an uncluttered classroom
• Create a personal bubble with tape, carpet square etc. to minimize poking, hitting, touching
• Lots of time, “10-second children in a 1-second world.” (Diane Malbin)
• Use only one book for writing in to minimize trying to find the right book in a disordered desk
• If he can handle it colour code books, get out your yellow book not Language Arts
• Have a quiet, soft place for de-stressing (not punishment) — bean bag chair, pillows, pup tent etc.
• If an assembly will be too stimulating, provide muted ear phones or keep child out of environment
• Do not ask why she did something or moralize. She does not know and morals are meaningless

Minimize homework. If it is causing too much stress it should not be done
• Let him have quiet “fiddle” toys — squishy balls, pocket full of rubber bands
• Sipping water from a sports bottle (straw attached, no spills) may help her attend to lesson
• If he can’t sit still a weighted blanket (large bean bag) may help him anchor his body in space
• Ensure you have eye contact with her when giving instructions, ask her to repeat simple directions
• Simplify complex directions and avoid multiple commands
• Make directions clear and concise and be consistent with daily instructions
• Develop some quiet cues (signs) to help him settle down, go to the quieting place when overstimulated
• Be firm when needed and give only limited choices.
• Make students feel comfortable with seeking assistance (most children will not ask for help)
• These children will need more help for a longer period
of time than the average child
• Remember he is not “misbehaving” on purpose to make you mad, “think brain not blame” (7)
• Analyzing, moralizing and traditional disciplinary methods do not work
• Behaviour modification and /or rewards/punishment will not work!
• Communication, patience, compassion, understanding and creativity do work — think fasd first!
• Provide transition help when switching over to middle, junior or high school
• Focus on life skill training, health and nutrition, job skills not higher academics
• Focus on communication, problem-solving, social and life skills — reality based education
• Try to incorporate math and literacy skills into life skills, eg. cooking, shopping, advertising etc.
• Continue to address high school student’s developmental, not chronological age (35)
• Routines are critical, these students may benefit from an “external brain buddy” to get to next class
• Fewer classrooms, classrooms close to each other works best
• Help her organize her locker and backpack
• Colour code subjects, yellow–math, red–English, blue– Family Studies — coloured stickers on texts


A special classroom for students with FASD features small class size, “personal bubbles” marked off with carpeting or tape, a low stimulus environment, easy read labels and laiminated cues, private spaces for de-stressing, private “time-in” spaces, and large bean bags for use as weighted blankets.

• Same locker and adult “external brain” year after year is helpful
• Use technology wherever practicable with these students — usually technologically savvy
• Provide fasd-aware tutors
• If what you are doing is not working, don’t try harder,
try differently!

FROM FASD TOOLKIT FOR ABORIGINAL FAMILIES PREPARED BY THE ONTARIO FEDERATION OF INDIAN FRIENDSHIP CENTERS

Strategies for FASD

Whole School Strategies (this represents a minimum)

• All staff in the school trained to understand how fasd affects students
• Substitute personnel trained to understand and deal with students with fasd
• Emergency support for substitute personnel and students if “the wheels fall off.”
• Teachers and aides with realistic expectations of functional development
• Ideal staff will have nurturing, flexible personalities and a sense of humour
• Full-time Educational Assistants
• Make student records easily accessible (understandable) to professionals within privacy limits
• Whole school behaviour expectations, eg. Tribes ™ or “With All Due Respect”
• Mark boundaries on floors, hallways if inappropriate touching and poking is a problem
• Direct supervision of all meals, snacks, recess, bathrooms, on the bus – 24/7 supervision
• Structure program as much as possible, no surprises, structure all routines and be consistent
• Buddy Program of fasd-affected student with unimpaired peer
• Direct supervision, if required, of all transit from place to place within the school
• Each fasd student should have an adult “buddy” within the school
• Be overcautious with safety — expect the unexpected — lock up all dangerous items
• Have these students “do in-school errands” (if capable) to use energy acceptably
• Prepare students carefully for assemblies, guest speakers or fire drills (provide ear protection)
• Communication books that go home and come back every day
• Work closely with parent(s)/caregiver(s) — “everyone on the same page” — “iron-clad” consistency
• The same teacher for more than one school year, minimizing transitions
• “Time-in” spots that are private, safe, easily supervised, low-stimulus and comfortable
• Aim for fun and enjoyment, enjoy good times with all students, Carpe diem.
• Staff need to learn to like the students with fasd as people
• Remember that students who are impaired teach life lessons to those who are less challenged
• Remember that students with fasd do not know why they do things, don’t ask!
• Foster interdependence not independence in the fasd affected, learn to use ‘external brains’
• When things are going poorly try something different, don’t try harder
• Life skills curriculum blending academic, daily living, personal/social and occupational skills
• Focus on helping students function well in the community with a minimal amount of supervision

FASD Reflections

FASD the preventable disability. Working with people with FASD can be extremely challenging. Not only do they have neurological deficits but social and learning difficulites as well.

Compromised executive functioning D
Difficulty planning, predicting, organizing, prioritizing, sequencing, initiating, and following through. Difficulty setting goals, complying with contractual
expectations, being on time, or adhering to a schedule.

➤ Difficulty with memory
Information input, integration, forming associations, retrieval, and output. Difficulty learning from past experiences. Often repeat the same mistake over and over again in spite of increasingly severe punishment. Inconsistent memory or performance; may remember on Monday, forget by Tuesday.

➤ Difficulty with abstract concepts
Such as time, math, or money.

➤ Impaired judgment
Often unable to make decisions. Difficulty understanding safety and danger, friend and stranger, or differentiating fantasy from reality.

➤ Inability to generalize information
Difficulty forming links and associations, unable to apply a learned rule in a new setting; learns to not take Johnny’s bike, but then takes Mary’s bike.

➤ Communication challenges
Appears to understand instructions, nod and agree, but is unable to comprehend. Often repeats rules verbatim, then fails to apply the rules — “talks the talk” but doesn’t “walk the walk.”

➤ Language problems
Difficulty comprehending the meanings of language and accurately answering questions. May agree or confabulate — comply or fill in the blanks. Many talk
excessively, yet are unable to engage in a meaningful exchange. The sheer volume of words creates the impression of competence.

➤ Slow cognitive pace
May think more slowly, say “I don’t know,” shut down, or require minutes to generate an answer rather than seconds. Those with fasd are “Ten‑second people in a one second world.”

➤ Slow auditory pace
Central auditory delays means language is processed more slowly, requiring more time to comprehend. Many only grasp every third word of normally paced speech.

➤ Preservation
May be rigid, get stuck, have difficulty switching gears, stopping an activity, or transforming to a new activity. Often react strongly to changes in setting, program or personnel.

➤ Dysmaturity
Often function socially, emotionally, and cognitively at a much younger level developmentally than their chronological age. A 5-year old may be developmentally more like a 2-year old, a 12-year old more like a 6-year old; and a 25-year old more like a 13-year old.

➤ Impulsivity
Coupled with inability to abstract and predict outcomes; acts first and then is able to see the problem after the fact.

➤ Sensory systems dysfunctions
May be over-reactive to stimuli — e.g. tactile defensiveness. May be easily overwhelmed by sensory input, may be unable to filter out extraneous stimuli; symptoms include increased agitation, irritability, and aggression. May under-react to pain — may not complain of earaches, broken bones, and be unable to experience painful stimuli.

Secondary Behaviours

Secondary behaviours are defensive behaviours that develop over time when there is a chronic “poor fit” between the person and his environment. Defensive behaviors are normal protective reactions to frustration and are helpful cues for identifying points of intervention.

By definition, these are preventable when a good fit is provided. Again, these are not exclusive of fasd.

• Inappropriate humor — the “class clown.”
• Pseudo-sophistication; may echo words, phrases, manners, and dress in order to “pass” as competent beyond their actual ability, often to their detriment.
• Fatigued, irritable, resistant, argumentative.
• Anxious, fearful, chronically overwhelmed.
• Frustrated, angry, aggressive, destructive.
• Poor self-concept, often masked by unrealistic goals or self-aggrandizement.
• Isolated, few friends, picked on.
• Family or school problems including fighting, suspension, or expulsion.
• May run away, have other forms of avoidance.
• Trouble with the law, addictions.
• Depressed, may be self-destructive, suicidal.

Secondary behaviors often develop in early childhood, frequently becoming patterns of behavior by adolescence. Secondary conditions come at a high cost to the individual, their family, and the community. Early identification of both primary symptoms and secondary behaviors is necessary in order to develop appropriate
interventions, or “accommodations” that prevent or resolve secondary behaviors.
Section 4 of this document (“Reason”) provides a useful table outlining primary and secondary behaviours and the kinds of interventions or “accommodations”
that work and don’t work in coping with them

(This breakdown of primary and secondary behaviours has been adapted from a presentation by Diane Malbin at the 2005 FASD National

Special Class An example of a school that has special classrooms for students with fasd is the David Livingstone Community School in Winnipeg, Manitoba.

“This is an Early Childhood Behavioural Treatment Program … designed for students who display severe behaviour resulting from fas/fae or other neurological difficulties. A description of the program is as follows:
low stimulus environment,low enrolment classroom, focus on social skills, behaviour and academics, strong consistent classroom agenda, individual education plans, predictable routines and expectations, behaviour plan consistently reinforced by Teacher Assistants and Support personnel, consistent consequencing, speech therapy on site two times a week, occupational therapy on site once a week.”

This program has had demonstrated success with students seriously affected with fasd.
Conference, “Equality of Access: Rights and the Right Thing to Do.”