A positive behavior support plan does much more than just addressing negative or difficult behaviors; it is a plan formulated through a collaborative effort from caregivers, teachers, therapists, and doctors in a child’s life. It is often used for children with learning difficulties, developmental disabilities, and autism. But before looking at exactly how to implement such a plan, perhaps we need to understand these so-called difficult behaviors.
Difficult behavior or (unmet) need?
Looking back to the start of the pandemic, many people remember the initial period as the toilet paper stockpiling phase. It is because this behavior was so baffling that it occupies such prominence in our memories. But if we believe what experts tell us, that every behavior serves a purpose or expresses an unmet need, then panic buying was not a random chaotic act.
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So what purpose did hoarding toilet paper serve, or should we ask what unmet need did the act express? The purpose was obviously not the pleasure of owning a lifetime supply of toilet rolls, more likely it was an expression of a need for some control when the world started wobbling.
Turns out, it probably was. A study (Garbe et al., 2020) suggests that those who felt more threatened by COVID-19 stockpiled more toilet paper. How did buying countless rolls of loo paper make a looming pandemic feel less scary? Scientists are not entirely sure, but knowing there was a reason behind the behavior makes it seem a little less bizarre—authorities doing more to address anxiety could probably have stopped or lessened the stockpiling.
All this to say, we all indulge in problematic behavior that may appear inexplicable. But the behavior serves a purpose, and if the purpose became apparent the behavior does not seem quite so bad. In fact, once underlying motivation is understood, an alternative “positive” behavior could be suggested to reach the same goal. Perhaps we should have been advised to stay home making masks, a positive behavior to replace stockpiling and hoarding—serving the same psychological purpose of doing something to control mounting anxiety.
Behavior intervention
So what would be the ideal way to address problem behavior? When it comes to our children we just want difficult behavior to stop as quickly and effortlessly as possible. Whatever it takes…rewards or even punishment are frequent weapons in the parental arsenal against challenging behaviors.
But if the problem behavior has a function, or if the behavior is a way to express an unmet need, rewarding or punishing the behavior may not be the answer. Applied behavior analysis (ABA) teaches us that behavior occurs as individuals get something out of it; ABA specifically targets the four functions of behavior which are:
- Escape: The child behaves in a way that may get him/her out of doing something he/she doesn’t like, or the behavior helps him/her avoid it all together
- Attention: Frequently a child’s problem behavior is simply a way to get attention from parents or teachers
- Access to tangibles: The child may display problematic behavior to gain access to something he/she likes or enjoys, for example a tantrum may result in more time on the iPad
- Automatic reinforcement: In this instance, the behavior actually provides the reinforcement; stimming (self-stimulatory behavior) is an example where the behavior itself feels good to the child
Understanding the function behind an autistic child’s difficult behavior often leads parents to behavioral research which suggests formulating a comprehensive plan to address the behavior appropriately with evidence-based principles and interventions.
A comprehensive plan for improved outcomes
For a child on the spectrum, difficult behaviors may interfere with education and social engagement. Improving the child’s quality of life may mean that the behavior needs to be altered. A positive behavior support plan is considered to be one of the best approaches to support children (on the spectrum) to address complex behavioral challenges. This approach is often successful because it:
- Includes a range of intervention strategies, but uses the least amount of intervention necessary
- It builds and encourages positive behaviors
- It is practical and adaptable to the various settings where behavior may need to be altered
- It provides guidance to adapt the environment
- It contains measurable goals
A positive behavior support plan
An article (Hieneman, 2015) describes positive behavior support as a process which integrates evidence-based principles from ABA and various other disciplines to address difficult behaviors. The article goes on to list the following features of positive behavior support:
- Improvement in quality of life
- Working and collaborating with caregivers
- Measuring progress in meaningful ways
- Comprehensive function-targeted interventions
It’s natural to assume that a written positive behavior support plan merely outlines how to help a child change challenging behavior. A positive behavior support plan’s reach, scope and purpose should be far more comprehensive. The plan should outline the proactive steps necessary to change the child’s environment and it should contain strategies to support teaching new and useful skills to the child. The written plan should keep everyone accountable, this means parents, teachers, therapists, and other caregivers should ensure adherence and buy-in when it comes to the plan.
Specifics of the document or plan
A behavior support plan should be individualized and tailored to the child’s specific circumstances to achieve social and learning goals or alter difficult behavior. This document is not a quick fix for a specific undesirable behavior; rather the plan should help children thrive across different settings such as school, home, and their community. Thriving should be based on the child’s specific preferences and those who execute the plan should understand the child’s unique environment.
There are various ways to formulate a document, contextual factors will dictate who collaborates to develop the plan. Those involved should view challenging behavior holistically, for this purpose the ABC approach is often suggested..
A,B,C’s behind the plan
Many experts simplify behavioral support plans to an ABC approach where:
- A: is for antecedent, or that which happens right before the behavior occurs
- B: is for behavior, or the observable activity that can be measured
- C: is for consequences, or that which happens immediately after the behavior
A special education teacher may observe a student’s difficult behavior in class and use the ABC model to analyze the function or motivation behind the behavior. For example, an autistic student’s behavior may be disruptive in a particular class. When collecting data about this behavior a teacher may notice that it usually occurs during math lessons. More specifically, the behavior usually occurs right after new work is introduced and explained. When the behavior becomes too disruptive, the child may be asked to leave the classroom.
In this example, the new math may cause anxiety (the explanation of new work, which the autistic child may find challenging or anxiety provoking, is the antecedent) leading to the disruptive behavior. The consequence of having to leave the classroom is the consequence. The child’s motivation, or the reason for the behavior, is to escape the challenging situation. When the child gets to leave class (instead of having to deal with the new math) the behavior achieves its function by allowing him/her to escape the situation.
A problem-solving process
According to the article referred to above (Hieneman, 2015) a positive behavior support plan is a “problem-solving” process based on ABA principles. It often includes the following:
- Setting goals and pinpointing problem behaviors
- Data and information gathering to aid recognition of patterns contributing to challenging behavior
- Choosing appropriate strategies based on such patterns, and formulating a comprehensive function-based plan
- The plan should be executed in various circumstances
- Behavior support plans should be implemented in various appropriate settings by parents, teachers and other caregivers in the child’s life
Hieneman (2015) emphasizes that the outcomes at different stages of a behavior support plan varies according to the individual.
Autism and a positive behavior support plan
When formulating a plan for a child on the spectrum, these principles seem especially relevant. The plan’s overall goal of enhancing quality of life, rather than a narrow focus on changing a specific behavior, is in line with that which experts recommend for behavioral issues in autistic children.
A focus on collaborating with all involved carers in the child’s life is also of great importance for a plan to be successful in various settings of the child’s life. Behavior interventions should be based on a functional behavior analysis that looks at why a child on the spectrum is behaving in a specific (problematic) manner—including the different settings where the behavior occurs and the caregivers involved when such behavior occurs.
The functional behavior analysis should enable data to be collected about the behavior—including circumstances surrounding the behavior, the ABC approach may be useful for this purpose—which should inform the process of formulating a hypothesis. A hypothesis is a statement that not only states the behavior but also that which preceded such behavior and the function or purpose of such behavior.
When clear information about the behavior is available, strategies and interventions to address the behavior can be detailed in the document or plan. Strategies pertaining to what precedes the behavior may include ways to change problematic situations or rearrange the environment.
In the example above the new math learning could be introduced to the child before class with extra help from a tutor if needed. When it is eventually introduced in class, it won’t be new and quite so challenging, which may remove the motivation to escape.
The positive behavior support plan could then focus on behavior replacement to replace the behavior of concern; in the example the child could ask for help to understand new coursework, or the child could be taught to self-regulate. Disruptive behavior could be replaced by behavior aimed at facilitation of learning, for example the child could be taught appropriate ways of seeking assistance and study methods focused on comprehension.
A comprehensive collaboration
Fortunately, the idea that autism is something that needs fixing, is being replaced by acceptance of a differently wired brain. Acceptance, however, does not mean that behavior interfering with the child’s quality of life can’t be altered. A positive behavior support plan is not a shortcut to fixing a difficult behavior. Instead it is a comprehensive plan that requires collaboration from caregivers to improve the child’s quality of life.
Behaviors causing challenges in daily living are seen in context; and strategies, interventions and replacement behaviors are implemented taking all circumstances into consideration. The plan encourages everyone in the autistic child’s life to work together to enhance his/her lifestyle and happiness.
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A parent who wants to help their child on the spectrum thrive should get teachers, therapists, and any other relevant people in the child’s life to collaborate and formulate a plan to address problematic behavior. The plan will always be based on the notion that the challenging behavior is aimed at a specific function or an expression of an unmet need. When such a need is met by a team which cares about the child (guided by a positive behavior support plan) there is usually no longer a need for the behavior and it disappears.
References:
Garbe, L., Rau, R., & Toppe, T. (2020). Influence of perceived threat of Covid-19 and HEXACO personality traits on toilet paper stockpiling. PloS one, 15(6), e0234232. https://doi.org/10.1371/journal.pone.0234232
Hieneman M. (2015). Positive Behavior Support for Individuals with Behavior Challenges. Behavior analysis in practice, 8(1), 101–108. https://doi.org/10.1007/s40617-015-0051-6
