Positive Behavior Support Strategies for Young Children with Severe

Disruptive Behavior
Raj Narayan Sharma
Wichita Public Schools

Shobra Singh
Wichita Public Schools

Jason Geromette
Wichita Public Schools

The occurrence of problem behaviors in the This article focuses on severe disruptive behavior
repertoires of young children with autism can (SDB), the management of SDB by the application of
represent substantial problems for the children’s positive behavior support strategies, and seeks to (a)
development, access to appropriate services, and provide a rationale for the use of PBS, (b) define the
the functioning of the children’s families (Dunlap PBS, (c) provide research support, and (d) discuss
& Fox, 1999). Although not all children with autism different PBS strategies for managing disruptive
display serious disruptive or destructive behaviors, behavior.
a large number exhibit behaviors such as self injury,
aggression, property destruction, and violent, Rationale for the use of PBS for children with
protracted tantrums. Disruptive Behavior
Positive Behavior Support (PBS) has emerged
as a behavioral support which focuses on ecological The main reason to encourage the use of PBS
relevance and meaningful outcome in the form of for managing disruptive behavioral concerns is that
lifestyle change (Carr et al., 2002). PBS is a strategy when a child with disability engages in a behavior
that attempts to reduce or eliminate inappropriate that impedes his or her learning or that of others, the
behavior. It utilizes a multi-component behavior Individual Education Program team must use the
plan. The plan has two features: functional behavior functional behavioral assessment (FBA) and positive
assessment and a comprehensive behavior plan. At behavior intervention planning process. Additionally,
the school-wide level, primary prevention focuses intervention must be FBA-based with the inclusion
on monitoring and preventing problem behaviors of all supporting staff in the child’s vicinity as well
across entire student populations. At the next level, as home members.
secondary prevention utilizes strategies aimed at
preventing increased behavioral problems among Steps in the PBS Process
students for whom primary prevention efforts have
been insufficient in facilitating success. Finally, Step 1: Identify the Target Behavior
tertiary prevention is directed at preventing crisis
and severe disruptive behaviors across larger life The very first step in this plan is to identify the
domains and is implemented with the students for target behavior. In the case study we chose Lila’s
whom both primary and secondary strategies have hitting behavior as the target behavior. The following
been unsuccessful (Scott, 2003). case vignette explains the procedure at a glance before
we delve into detailed explanation of the plan.

The Journal of the International Association of Special Education 2008 9(1) 117
Behavior Background Vignette observations and determined that Lila was using
her challenging behavior to avoid sharing toys or
Lila is a four-year-old girl attending a preschool engaging in activities that she did not like.
program. She has recently been diagnosed with Step 5. The function of the behavior was
autistic spectrum disorder. She yells and screams found to be attention and escape. The next suitable
when asked to do work during the activity periods, replacement skill was explored and functional
hits other children, pulls hair, bites, destroys toys communication training implemented (i.e., for
and materials, and resists redirection. Her parents teaching her how to seek positive attention). It seems
are concerned that at home she yells if she is not able that she was not following what to do in her class
to watch T.V. when she wants. This is the first time routine and consequently did not know what she was
that Lila has been in a group care setting. In the first expected to do.
months of her enrollment, her teacher thought that Steps 6-8. The team developed a behavior
Lila just needed to learn the classroom expectations support plan based on their new understanding of
and get used to being with other children. Now it is Lila and the function or purpose of Lila’s challenging
half way through the school year and Lila’s behavior behavior. The following prevention strategies were
has not improved. Her classroom teacher, together used: warning Lila of transitions with a countdown
with Lila’s parents and the School Psychologist, cue (e.g., “five more minutes, three more minutes,
established a home/school plan to remind Lila one minute, time for circle”); watching Lila carefully
of the classroom rules. Currently, the School during center time and facilitating peer interaction
Psychologist works with Lila for 30 minutes each when peers approached Lila; and setting a timer for
week. Unfortunately, Lila’s behavior is unchanged. Lila that showed her how long she could play with
Her classroom teacher is ready to give up. She isn’t a highly desired object before offering the toy to
sure at this point if she can meet Lila’s needs in the another child. In addition to these strategies, the team
program. After much discussion with Lila’s family modified activities and transitions that were difficult
and the school psychologist, we decide to try Positive for Lila. For example, at circle time, the teachers
Behavior Support Strategies. added a choice board that allowed Lila to pick the
Step 1. The hitting behavior was selected as the song that would be sung on arrival at circle.
target behavior. This decision was made based on Let’s see how the visual schedule works for her.
both the input of her parents and teacher as well as As can be seen in figure 3, mini individual schedules
the nature of her behavior. According to her parents were prepared for each of the class routines. Also she
this behavior offends her younger brother and causes was given a picture cue card for “I Want” and trained
chaos at home. Moreover the behavior needs attention in various settings for how to communicate using it.
as it is causing physical harm to persons around her. This was chosen as she does not verbalize more than
Steps 2-4. The functional behavioral assessment ten basic sight words.
process included observing Lila during her routines
at school and home. Each member of the team wrote Outcome
down what happened, both before Lila’s challenging
behavior and after. The team learned from their As illustrated in Figure 7, during the first baseline,
observations that Lila was most likely to engage in Lila’s hitting behavior occurred, on average, eight
challenging behavior when another child tried to play times per day. During intervention Phase One, hitting
with a toy that Lila had chosen. When Lila attacked behavior came down to one time a day at the end
the child by hitting, biting, or grabbing a toy, the of five days of intervention and it again increases to
teacher would comfort the hurt child and then take four times a day in the second baseline. In the second
the hurt child to another center or activity. Thus, Lila intervention phase, the behavior decreases to zero
would be successful in getting that child to leave the times a day. Data was taken over twenty days.
activity or leave the toy. The team discussed these

118 The Journal of the International Association of Special Education 2008 9(1)
 Step 2: Recording System Strategies for teaming with families in the process
of PBS include (a) reviewing the process with the
We selected event recording (as in Figure 1) as family using a question and answer sheet developed
the recording method for measuring the behavior. for each child on PBS, (b) asking the family to
For hitting behavior it is best to measure the number provide observation information, (c) interviewing the
of times she hits. This type of recording will be family using the functional behavioral assessment
comprised of making a notation for every time she process, (d) identifying problem behaviors/situations
hits in a defined time period (i.e., a thirty minute that are similar across home and school, (e) sharing
class period). It will most directly reflect the behavior hypotheses and a draft support plan with family
frequency. members and encourage giving ideas, (f) developing
a simple plan for home implementation, (g) providing
Step 3: Procedure and Strategies the family with success stories, and (h) encouraging
each family by praising their efforts and progress.
Let’s Build a Team The special educator sends home a form for
parents to complete, which is based on open-ended
The first step in the PBS process is to convene a questions about Lila’s problem behavior. Similarly all
team of individuals who have the best interests of the the therapists working with her (such as her speech
child with autism in mind. This collaborative team therapist) are given the form.
could include a speech language pathologist, the
student’s teacher, paraprofessionals and other related Step 4: Comprehensive Functional
service personnel, peers, and always family. Behavioral Assessment
Dates Time Notation of Total
of data occurrences occurrences Once the team is formed and engaged in goal
collection of hitting
and
identification, a comprehensive FBA should be used
throwing to provide a clear description of the challenging
Start Time Stop Time behavior (Susan & Johnston, 2001).

10/25/2004 10 AM 10:30AM IIII 5

Rationale
10/26/2004 10 AM 10:30AM III 3
The goal of an FBA is to gain an understanding
10/27/2004 10 AM 10:30AM IIII 4 of the function of the challenging behavior and when
the behavior is most and least likely to occur. The
10/28/2004 10 AM 10:30AM IIII 5 best way to intervene with the problem behavior is to
first find out what is the communicative intent of the
10/29/2004 10 AM 10:30AM IIII 4
problem behavior. This particular FBA is done using
10/30/2004 10 AM 10:30AM III 3
antecedent, behavior, consequence (ABC) cards (i.e.,
each of the staff can use them during playground
11/31/2004 10 AM 10:30AM II 2 sessions and class sessions, such as the assistant
instructor is given that card to record the antecedent,
10/01/2004 10 AM 10:30AM II 2 behavior and consequence of behavior). A teacher
can use the following method for doing a successful
10/02/2004 10 AM 10:30AM I 1 functional assessment.
10/03/2004 10 AM 10:30AM 0

Figure 1. Event Recording.

The Journal of the International Association of Special Education 2008 9(1) 119
Name: Observer: Date:
General Context: Time:
(A) Trigger:
(B) Challenging Behavior:

(C) Maintaining Consequences:

Possible Function:

Figure 2. Sample Observation Card.

Making an Observation Card Long Term Support

As can be seen in Figure 2, it is a simple 4X6 Long Term Supports are statements including
inch card which has three columns to be filled out by strategies and supports to assist the child’s overall
an observer of the behavior in a social context which health, development, and social interaction. These
does not involve teachers. It can then be handed over might include anything from scheduled team
to a teacher or the parents who can hand it in to the meetings and the instruction of team members in
special education teacher for further analysis. support strategies to medical management of the
child.
Step 5: Best Hypothesis Development
Prevention Strategies
The above functional assessment should lead
one to the development of a hypothesis that is a Prevention strategies include antecedent ma-
statement representing the best-informed guess about nipulations in the environment, activities, and others’
the relationship between the challenging behavior interactions with the child, especially attending to
and the communicative function of the behavior. the cues that have been identified as working for the
Typically a hypothesis can lead to four factors: (a) child. This is not limited to physical indicators or
attention, (b) escape, (c) tangible, and (d) sensory. triggers followed by individual problem behaviors
Let’s see how an FBA helps to identify the function. and their characteristic patterns.

Step 6: Developing a Positive Behavior Physical Structure of the Classroom

Support Plan Determine the following: (a) is there enough
workspace for individual and group activities, (b)
The four components of the plan include (a) long are the work areas located in the least distracting
term support, (b) prevention strategies, (c) physical locations, (c) are there distracting features in the
structure of the classroom, and (d) schedules in the classroom, (d) are the work materials easily accessible
classroom. by students, (e) do the work areas have visual cues
associated with them, (f) do students know where to

120 The Journal of the International Association of Special Education 2008 9(1)
 TIMINGS ACTIVITIES

put the finished work,9:00

(g) are the student materials
Student Arrival Timings Activities
clearly marked for easy access to them, and (h) are
play areas located away from exits?

Schedules in the Classroom 9:00 Student Arrival

Does the classroom have group schedules posted

in a centralized area? Does every student haveSession 2
10:00
individual visual schedules posted for him or her?
9:30 transition warnings?
Session 9:30 Session 1
Does the schedule involve 10:00 1 Session 2
10:00 Session 2
Objective of individual schedule. To help students
understand what to do during the activities listed10:00in Session 2
10:00 10:00
Session 2 Session 2
the general schedule.
Materials needed. The materials10:30needed include:Computer time10:00 Session 2
(a) pictures depicting steps to be done during10:30 each Computer time
session, (b) bulletin board, and (3) clips. 10:30 10:30 Computer time
Computer time
10:30 Computer time
Activity. Place a small bulletin board beside 10:30 Computer time
the child’s working area. Clip four to five pictures
10:30 Computer Time
depicting steps to be done during 11:00each activity inGet Ready for Lunch
either a vertical or horizontal, left to right11:00
manner. Get Ready for Lunch
11:00 11:00
11:00 Get Ready
Getfor
Get Lunch
Ready
Ready for
for Lunch
Lunch
It will be more relevant to students if their picture 11:00 Get Ready for Lunch
is used. An example of an individual schedule is in
Figure 3. The student starts with the topmost picture 11:00 Get Ready for Lunch
and finds materials needed, completes the activity,
and puts the materials away. 11:15 Lunch
11:15 11:15 11:15 LunchLunch Lunch
For a session, which includes writing,11:15a visual Lunch
11:15 Lunch
schedule could be made, as shown in Figure 3. Note 11:15 Lunch
that getting ready for lunch and packing are transition 12:15 Session 3
warnings included in a schedule. This is a schedule 12:15
for Session 3
children who comprehend at a concrete picture
12:15 12:15level.Session
Session
312:1533 Session 3
12:15 Session
One can use clip art instead of magazine pictures
12:45 Pack Up
12:15 Session 3
depending upon the level and skill of the child.
12:45 Pack Up
12:45 Pack Up
12:45
Step 7: Developing Replacement Skills Pack Up
12:45
12:45 Pack Up
Pack Up
Some non-verbal children have achieved 12:45 Pack Up
functional communication of first words by means of
word cards. When visual representations or product
labels are paired with written words, children
1:00receive Dismissal
additional visual cues. Several word cards may be
1:00 Dismissal
joined together for instructional sequences.
Figure 4 is a sample for usage of a visual word
card for developing functional communicationFigure 3. Sample of Group Schedule (Rachel, can you make sure the rows here are evenly
Figure 3. Sample of Group Schedule.
training in children with autism. This can be taught
distributed and the clip art…can you make sure they are right flush lined up and sized
as a replacement skill for children who do not
understand when asked to wait and hence word card the same? This Table could be put on one entire page. Thanks)
approximately

The Journal of the International Association of Special Education 2008 9(1) 121
usage serves the purpose of teaching these children
to communicate.
Green
Objective of the Strategy
As can be seen in Figure 4, when shown the
“wait” card, the student will wait for five minutes in
four-week period with 100% accuracy. Yellow
Materials
One 3 x 5 inch index card and a picture or clip art
depicting meaning of the word “wait”
Procedure
Red
Use a 3 x 5 inch index card and print the word Figure 5. Green, Yellow, and Red Cards.
1:00 Dismissal
“wait” on it. Practice for this takes two or three
seconds several times per day. Each time the child to understand they cannot get the “goodie” without
practices using the “wait” card increase the time. the wait card.
Hold a “goodie” in your lap, and tell the child you
are going to giveFigure
it to him or her. of
Hand the Schedule
“wait” (Rachel, can you Step 8: Consequence Strategies
3. Sample Group make sure the rows here are evenly
card to the child while saying, “Please wait.” Almost
immediately, givedistributed
the child and
the “goodie” with one Students in PBS, especially students with
the clip art…can you make sure they are right flush lined up and sized
hand while taking the “wait” card with the other and autism, require concrete and relevant praise for
saying “Thank youapproximately
for waiting.” the
Slowly increase
same? the couldskill
This Table
demonstration. For children with autism, the
be put on one entire page. Thanks)
“wait” time. development of a token system based on visual cues
Note that a younger child cannot wait too long may work as a consequence strategy. Here is one
anyway, but this system really helps them learn how sample of such strategy:
to wait. The “wait” card can be used to help children
Objective of the Strategies
take turns in a circle and wait in line to leave the
classroom. A teacher may hand a “wait” card to a To provide extra computer time as a reinforcement
child along with the computer icon to help the child when a student completes an activity and redirecting
wait when the teacher needs to change a program. the student to an activity when tantruming.
Objects can also “wait.” For instance, a puzzle that
needs to be finished at a later time can “wait” for the Materials
child to return. The “wait” card may be placed on As can be seen in Figure 5, three 3 x 5 inch green,
top of the puzzle. Some very young children do not yellow, and red cards.
quite understand the concept of “wait,” but do seem
Activity
Each time the student begins an activity, the
teacher turns the white card in the poster to green.
Now as long as the student remains on the activity,
she is on green card and she earns twenty minutes
extra computer time for this session. As soon as the
student starts showing problem behavior, the red card
Figure 4. “Wait” Card becomes visible, and the student’s computer time for
Figure 4. “Wait” Card.

122 The Journal of the International Association of Special Education 2008 9(1)
that day is reduced by ten minutes each time. Note References
that depending upon the child, the teacher can use
variety of reinforcers. Carr, E. G., Dunlap G., Horner R. H., Koegel, R.
L., Turnbull, A. P., & Sailor, W. et al. (2002).
Conclusion Positive behavioral support: Evolution of an
applied science. Journal of Positive Behavior
Positive behavior support has emerged as one Intervention, 4(4), 507-531.
of the most effective fields of behavior intervention Dunlap, G. & Fox, L. (1999). A demonstration of
for children with behavior and emotional problems. behavioral support for young children with autism.
Previously, the concept was to be used at broader Journal of Positive Behavior Interventions, 1(2),
levels such as school based positive behavior support 77-87.
programs. Lately it is gaining importance at narrower Scott, T. M. (2003). Making behavior intervention
levels, for example at the classroom level. Teachers planning decisions in a school wide system of
of young children with special needs have the extra positive behavior support. Focus On Exceptional
responsibility of using PBS as an early intervention Children, 36(1), 1-18.
tool at the classroom level. It is at this early stage
that the teacher involves parents and all professionals
related to the child to actively participate in the
child’s negative behavior reduction plan. It is very
important for the teacher to fully involve the parents
in the process. The teacher may want to incorporate a
checklist after employing various means of informal
and formal procedures for the functional behavioral
assessment. Next, after the communicative intent
of the behavior is recognized, the teacher should
design the replacement skill, for example, functional
communication training for the successful behavior
intervention program for the child. Hence, Positive
Behavior Support could be a framework within
which parents, teachers, and professionals work
together for replacing problem behaviors of a child
with alternative positive behaviors, which prove to
be effective in meeting the communicative intent of
the behavior.

The Journal of the International Association of Special Education 2008 9(1) 123