A POPARD consultant found herself called upon to respond to the needs of students with challenging behaviours that local school staffs are unable to manage effectively. While consultation is effective case–by–case, she found that problematic behaviours re–occurred because the capacity of the school staff to manage challenging behaviours was often not sufficiently enhanced by individual consultations.
The Prevent–Teach–Reinforce model of behaviour support is a uniquely school–based systems intervention in that it has been designed for use in school settings – many school teams identify problem behaviour as one of their most pressing concerns in school programs for students with autism.
The consultant decided to use the Prevent–Teach–Reinforce model to work with a school team to complete functional assessments and develop and implement strategies to address the problem behaviours of students with autism spectrum disorders. Her decision reflected the need to increase the capacity of school–based–teams to address problem behaviours.
Prevent–Teach–Reinforce (PTR) is a standardized individual Positive Behaviour Support approach developed by Glen Dunlap et al. (2010). Dunlap conceptualized a model that includes systematic school–based practices intended to prevent misbehaviour before it occurs and to respond to it with positive behaviour supports when it does occur.
The model involves Primary, Secondary, and Tertiary levels of prevention and support and begins with policies formulated for the majority of students and ends with procedures formulated for the minority of students whose misbehaviour poses frequent and intense challenges to the welfare of themselves and those in their company.
Primary prevention involves school–wide systems for prevention of misbehaviour and support of all students and staff.
Secondary prevention involves systems for preventing misbehaviours among students who are considered at–risk for misbehaving (about 15 % of students). Tertiary prevention is intended for the few students (about five percent or fewer) who are considered to be at high–risk for misbehaviour.
The first essential component of PTR (Figure 2) is the establishment of one or more teams on site, that are focused on managing problematic student behaviours. Membership on a team involves commitment and agreement to attend regular meetings. Team members develop expertise by collaborating, asking questions, brainstorming, making data–based decisions, and sometimes assisting with implementation of an intervention. Roles within a team include being a facilitation, setting agendas, recording and keeping time.
The second component of PTR is Goal Setting and Data Collection. The team members work to identify problematic behaviours and possible replacement behaviours. They determine and define target behaviours, short–term goals and collect baseline data.
The Behaviour Rating Scale is used to assist in data collection. It is very flexible and can be used to measure intensity, frequency, duration, etc.
For example, if the target behaviour is voice that is too loud, indvidualized “anchors” can be written and data on them can be collected (Figure 3):
For example, if the target behaviour is voice that is too loud, indvidualized “anchors” can be written and data on them can be collected (Figure 3):
The third component is Assessment during which team members consider antecedents, functions and consequences of problem behaviours – and that leads the team to develop interventions: to prevent the misbehaviour, to teach an alternate (more acceptable) behaviour and to reinforce the desired alternate behaviour (Figure 5). A behaviour plan is written by the facilitator.
The plan is based on the hypothesis accepted by the team as to the function of the behaviour. It includes prevention strategies, teaching acceptable replacement behaviour, and strategies to react to the behaviour. The replacement behaviours should be functionally equivalent to and/or incompatible with the target behaviour.
They must be more reinforcing for the student than the targeted challenging behaviour. And the team must try to arrange circumstances in such a way that the undesired behaviour is no longer reinforced.
The fourth component of PTR involves team members in Intervention and Coaching. School resources (staff time, materials) are assembled to support the intervention; teaching the alternate behaviour begins outside of the class or location where the inappropriate behaviour occurs and then moves into the environment.
The last component in PTR requires evaluation of the intervention. If the intervention is not working, the team must consider whether the initial hypothesis of the function of the behaviour is correct, if intervention is carried out effectively, or if more data is needed. If intervention is working, the team must consider how to maintain it.
In this project . . .
Our consultant intended to evaluate the use of PTR in a small rural school (Kn to Grade 7) in British Columbia. Two students with a diagnosis of autism had been referred for POPARD support because of substantial behaviour problems (hitting, spitting/ throwing objects). One of the students was withdrawn from the project early on; the project continued with the remaining student.
Team Building
Our consultant met with the school team to present the PTR process and to assist the team in organizing members and implementing their roles. Observations were performed to gather data on one the student’s problematic behaviours, before and after intervention, as part of the PTR process. Goal–Setting & Data Collection
Observations were gathered during November on throwing (Figure 6). The student threw an object at least once on every day recorded and, on some days, as often as three times. Spitting was not recorded.
Assessment
The team hypothesized that during transitions or the introduction of a non–preferred activity the student spat or threw objects. The result of his behaviour was that the transition or the introduction of a new task was delayed.
Intervention & Coaching
With assistance from their POPARD consultant, the team designed an intervention that began with Prevention: a visual schedule with consistent routines was constructed; a timer was introduced to encourage consistency and predictability; a pocket into which the student could insert “finished” work was provided; activity schedules were displayed, and a choice board was introduced to encourage the student’s participation in transitions. Teach: the alternate behaviours that were to be taught to him included asking for a break and asking for more time on an activity.
Reinforce. It was decided to reinforce the student for completing a task, including putting finished work in the pocket; more verbal praise was also introduced. The student received a small toy at the end of the day from the principal for completing activities, and reinforcement of hitting and spitting was minimized.
What Happened?
Student. Subsequent to implementation of the interventions, the student was observed again (Figure 7).
On most days observed (80%) the student neither spat nor threw an object. On four days (20 %) he engaged in one or the other behaviour or both. The median for spitting/throwing is, nevertheless, lower than the median of the throwing behaviour reported at baseline. This represents a decline in one of the targeted behaviours.
Team Evaluation. The school team was asked to complete the PTR Classroom Team Survey (Figure 8). Anecdotal remarks from team members were generally positive. Staff liked the process.
Once trained, staff found the BRS to be user–friendly and do–able. Training and coaching by the POPARD consultant were appreciated.
Once trained, staff found the BRS to be user–friendly and do–able. Training and coaching by the POPARD consultant were appreciated.
Among the limitations identified was limited release time for staff for training as well as time to attend PTR meetings. Instruction in the use of PTR materials occupied more time than was anticipated.
An important issue is that the Primary Prevention portion of PTR was not in place at the time of the project. If a school–wide Positive Behaviour Support system had been in place to provide a context for Tertiary prevention, it is reasonable to suggest that implementation of this project would have been easier because there would have been an over–arching system in place that would have provided a context for training staff in dealing with more intense behaviours. This project was implemented without the contextual support of a school–wide system, and that posed implementation issues that complicated the response of staff to training and intervention.
Recommendations for staff wishing to use the PTR model include:
- Recommendations for staff wishing to use the PTR model include:
- Involving school administrators
- Involving families
- Providing release time for training and for monitoring interventions
References
Dunlap, G.Iovannone, R.Wilson, K.Kincaid, D.& Strain, P. (2010). Prevent–Teach–Reinforce: A School–Based Model of Individualized Positive Behavior Support. Baltimore: Paul H. Brookes Publishing Co.
Dunlap, G.Iovannone, R.Wilson, K.Kincaid, D.& Strain, P.(2010). Prevent–Teach–Reinforce: A Standardized Model for School–Based Behavioral Intervention. Journal of Positive Behavior Interventions, 12,9–22.
Iovannone, R.Greenbaum, P.Wang, W.Kincaid, D.Dunlap, G. & Strain, P. (2009). Randomized Controlled Trial of the Prevent–Teach–Reinforce (PTR) Tertiary Intervention for Students with Problem Behaviors: Preliminary Outcomes. Journal of Emotional & Behavioral Disorders. 17, 213-‐225.
Inquiries related to this project can be addressed to
info@autismoutreach.ca
