Educating Children with Autism (2001) / Chapter Skim
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10 Problem Behaviors
10 Problem Behaviors
Pages 115-132
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From page 115... ...
Concerns about school behavior problems led to new standards and procedures for discipline, student suspension, and expulsion in the 1997 amendments to the Individuals with Disabilities Education Act (IDEA, 1997; Department of Education IDEA regulations, March, 1999~. Specifically, the regulations include provisions for the use of functional behavioral assessments and positive behavioral interventions and support.
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From page 116... ...
Chapters 5 through 9 discuss the essential elements (communication, social interaction, cognitive features, adaptive behaviors, and sensorimotor skills) needed for effective, appropriate educational programs for children with autistic spectrum disorders to address core problem behaviors.
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From page 117... ...
Berkson and Tupa (2000) found that about 5 percent of toddlers with developmental disabilities (including autistic spectrum disorders)
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From page 118... ...
Young children with poor social skills or limited communication, including children with autistic spectrum disorders, are especially at risk for such problems (BorthwickDuffy, 1996; Koegel et al., 1992~. An analysis of five reviews of intervention approaches for the general population of individuals with developmental disabilities, conducted between 1976 and 2000, found that the target behaviors most often addressed in intervention studies were aggression, destruction of property, disruption of activities, self-injury, stereotypic behavior, and inappropriate verbal behavior (Homer et al., 2000~.
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From page 119... ...
Reviews of eight model comprehensive early intervention programs (Dawson and Osterling, 1997; Harris, 1998; Rogers, 1998) , taken together, identified several critical elements common to many programs that addressed problem behaviors (a more extensive review of program elements is provided in Chapter 12~: · curriculum content that emphasized direct instruction in basic skill domains and abilities: attending to elements of the environment that are essential for learning, especially to social stimuli; imitating others; comprehending and using language; playing appropriately with toys; and interacting socially with others; · highly supportive teaching environments and generalization strategies; · predictability and routine; · a functional approach to problem behaviors;
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From page 120... ...
Since the mid-1980s, applied behavior analysis prevention strategies have focused on antecedent conditions in the child or the environment that set the stage for or trigger the problem behaviors (Carr et al., l999c) ; some of these are discussed below in the sections on positive behavioral interventions and supports and functional behavioral assessment.
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From page 121... ...
. AFTER THE FACT: TEACHING ALTERNATIVE BEHAVIORS Consequence-Based Approaches Most empirically based intervention approaches designed to reduce or eliminate specific, identified problem behaviors have an applied behavior analysis theoretical base.
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From page 122... ...
Although such an approach is implied in much of the research described above, a more formal approach to functional behavioral assessment has evolved in the literature and is required in certain cases of discipline under IDEA (see, for example 34 C.F.R., 300.520, 1999~. The functional behavioral assessment process typically involves: · identifying the problem behaviorist; · developing hypotheses about the antecedents and consequences likely to trigger or support the problem behavior; · testing the hypotheses; and · designing an intervention, based on the conclusions of the assessment, in which antecedents or consequences are altered and the child's behavior is monitored.
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From page 123... ...
Three findings on functional behavioral assessment emerge from 10 reviews of research from 1988 to 2000 on problem behaviors in persons with developmental disabilities including autistic spectrum disorders (Homer et al., 2000~: (1) functional behavioral assessment results more frequently in the choice of positive rather than punishment procedures than do problem reduction strategies not starting from functional behavioral assessment; (2)
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From page 124... ...
Positive behavioral interventions and supports include (Turnbull et al., 1999~: 1. systems change (e.g., the process of considering, modifying, or substantially changing an agency's policies, procedures, practices, personnel, organization, environment, or funding)
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From page 125... ...
The concept of positive behavioral interventions and supports represents a theoretical, scientific, and legal attempt to bring all aspects of these successful, positive interventions to bear on resolving behavior problems in children with autism or other disorders. A total of 366 outcomes of positive behavioral interventions and supports were examined in a detailed review of applied behavioral analysis studies of persons with autistic spectrum disorders (10%)
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From page 126... ...
For behavioral interventions that addressed such targets as dangerous self-injury in institutionalized adolescents with profound mental retardation, random assignment, accurate diagnosis, and independence of evaluation may have been of less concern than developing an immediately implementable effective individualized program. However, in order to evaluate treatments for milder difficulties in young children with autistic spectrum disorders, provision of standard, descriptive information about subject selection, subject characteristics and other aspects of research design is crucial in determining what approaches will be most effective for which children.
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From page 127... ...
can be refuted by evidence to the contrary, but positive behavioral interventions and supports is the only intervention strategy specifically required for consideration by IDEA; other strategies may be considered. If positive behavioral interventions and supports is seen as a rebuttable assumption, it means that an IEP team can consider other intervention strategies only in comparison with positive behavioral interventions and supports and must have adequate cause for adopting a different strategy.
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From page 128... ...
Medications to Reduce Behavior Problems Although a comprehensive review of medications and medical interventions is beyond the scope of this report, because of the widespread use of psychoactive medications, they are addressed briefly as they relate to problem behaviors in young children with autistic spectrum disorders. Psychoactive medications alter the chemical make-up of the central nervous system and affect mental functioning or behavior.
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From page 129... ...
Medications have been shown in some instances to enhance and to be enhanced by systematic, individualized behavioral intervention programs (Durand, 1982; Symons and Thompson, 1997~. More than 100 articles have been published on the use of psychoactive medications for autistic spectrum disorders.
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From page 130... ...
· Functional behavioral assessment to determine the functioned of the problem behaviors increases the likelihood of choosing the correct medication and behavioral interventions. Research is under way to predict responders and nonresponders to medication and to determine which children will benefit from behavioral treatment alone and what combinations of medication and behavioral treatment are most effective.
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From page 131... ...
notes as the clinical equivalent of "open trials." Broader implementation and evaluation of functional behavioral assessment and positive behavioral interventions and supports should lead to an expanded array of effective strategies for the majority of
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From page 132... ...
In the meantime, researchers, educators, and parents should not ignore testable, not yet fully assessed methods or measures that hold promise for reducing problem behaviors in children with autistic spectrum disorders. IDEA sets up perhaps the most practical and in some ways the most difficult challenge that of generating a functional analysis of each child's behavior to fashion an individualized program that will enable the child to progress and to participate in the academic and social life of family, school, and community.
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