Positive Behavior Support - Detailed Information

Positive Behavior Support

Positive Behavior Support (PBS) is a process for understanding and resolving the problem behavior of children that is based on values and empirical research. It offers an approach for developing an understanding of why the child engages in problem behavior and strategies for preventing the occurrence of problem behavior while teaching the child new skills. Positive behavior support offers a holistic approach that considers all factors that impact on a child and the child’s behavior. It can be used to address problem behaviors that range from aggression, tantrums, and property destruction to social withdrawal.

The Process of Positive Behavior Support

The following steps are essential to the process of PBS. 

1. Building a Behavior Support Team-PBS begins by developing a team of the key stakeholders or individuals who are most involved in the child’s life. This team should include the family and early educator, but also may include friends, other family members, therapists, and other instructional or administrative personnel. 

2. Person-Centered Planning-Person-centered planning provides a process for bringing the team together to discuss their vision and dreams for the child. Person-centered planning is a strength-based process that is a celebration of the child and a mechanism of establishing the commitment of the team members to supporting the child and family. 

3. Functional Behavioral Assessment-Functional assessment is a process for determining the function of the child’s problem behavior. Functional Assessment or Functional Behavioral Assessment (FBA) involves the collection of data, observations, and information to develop a clear understanding of the relationship of events and circumstances that trigger and maintain problem behavior. 

4. Hypothesis Development-The functional assessment process is completed with the development of a behavior hypothesis statement. The behavior hypothesis statements summarize what is known about triggers, behaviors, and maintaining consequences and offers an informed guess about the purpose of the problem behavior. 

5. Behavior Support Plan Development-Once behavior hypotheses statements are developed to summarize the data gathered from the functional assessment process, the team can develop a behavior support plan. Essential components of the behavior support plan are prevention strategies, the instruction of replacement skills, new ways to respond to problem behavior, and lifestyle outcome goals. 

6. Monitoring Outcomes-The effectiveness of the behavior support plan must be monitored. This monitoring includes measurement of changes in problem behavior and the achievement of new skills and lifestyle outcomes. 

PBS in schools

Schools are required to conduct functional behavioral assessment (FBA) and use positive behavior support with students who are identified as disabled and are at risk for expulsion, alternative school placement, or more than 10 days of suspension. Even though FBA is required under limited circumstances it is good professional practice to use a problem-solving approach to managing problem behaviors in the school setting (Crone & Horner 2003).

The use of Positive Behavior Intervention Supports (PBIS) in schools is widespread (Sugai & Horner, 2002). 

The program offers a primary, secondary, and tertiary level of intervention. 

A basic tenet of the PBIS approach includes identifying students in one of three categories based on risk for behavior problems. Once identified, students receive services in one of three categories: primary, secondary, or tertiary. To help practitioners with differences in interventions used at each of the levels the professional literature refers to a three-tiered (levels) model. Interventions are specifically developed for each of these levels with the goal of reducing the risk for academic or social failure. These interventions may be behavioral and or academic interventions incorporating scientifically proven forms of instruction such as direct instruction. The interventions become more focused and complex as one examines the strategies used at each level.

Primary prevention strategies focus on interventions used on a school-wide basis for all students (Sugai & Horner, 2002). This level of prevention is considered "primary" because all students are exposed in the same way, and at the same level, to the intervention. The primary prevention level is the largest by number.  Primary prevention strategies include, but are not limited to, using effective teaching practices and curricula, explicitly teaching behavior that is acceptable within the school environment, focusing on ecological arrangement and systems within the school, consistent use of precorrection procedures, using active supervision of common areas, and creating reinforcement systems that are used on a school-wide basis.

Secondary prevention strategies involve students (i.e., 10–15% of the school population) who do not respond to the primary prevention strategies and are at risk for academic failure or behavior problems but are not in need of individual support (Nelson, et al., 2002). Interventions at the secondary level often are delivered in small groups to maximize time and effort and should be developed with the unique needs of the students within the group. Examples of these interventions include social support such as social skills training (e.g., explicit instruction in skill-deficit areas, friendship clubs, check in/check out, role playing) or academic support (i.e., use of research-validated intervention programs and tutoring). Additionally, secondary programs could include behavioral support approaches (e.g., simple Functional Behavioral Assessments [FBA], preconception, self-management training). Even with the heightened support within secondary level interventions, some students (1–7%) will need the additional assistance at the tertiary level (Walker et al., 1996).

Tertiary prevention programs focus on students who display persistent patterns of disciplinary problems (Nelson, Benner, Reid, Epstein, & Currin, 2002).Tertiary-level programs are also called intensive or individualized interventions and are the most comprehensive and complex. The interventions within this level are strength-based in that the complexity and intensity of the intervention plans directly reflect the complexity and intensity of the behaviors. Students within the tertiary level continue involvement in primary and secondary intervention programs and receive additional support as well. These supports could include use of full FBA, deescalation training for the student, heightened use of natural supports (e.g., family members, friends of the student), and development of a Behavior Intervention Plan (BIP).

Although comprehensive services are important for all students, a critical aspect of the three-tiered model is the identification of students at one of the three levels. One method of identifying students in need of interventions is to analyze office disciplinary referrals (ODR) taken at the school (Irvin et al., 2006). ODRs may be a means of both identifying students' risk level for antisocial behavior and school failure (Walker et al., 1996). Researchers have advocated analyzing this naturally occurring data source as a relatively cheap, effective, and ongoing measurement device for PBS programs.

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Foundations of Positive Behavioural Support 

PBS (Positive Behavioral Supports) is the recommended form of intervention for dealing with challenging behavior in children with disabilities.  The Behavior Support Team (BST) implements PBS at the school, classroom and individual levels.  The foundations and features of PBS provide the framework of the BST consultations endeavors.

Foundations and Features of PBS –

Human behavior is affected by behavioral, bio-behavioral, social, and physical environmental factors and human behavior is learned and can be changed. Interventions emphasize environmental redesign, curriculum redesign, and removing rewards that inadvertently maintain problem behavior. Teaching is a central behavior change tool.  Research-validated practices are emphasized.   Intervention decisions are data based. Behavior change must be socially significant, comprehensive, durable, and relevant. The goal of our consultation is enhancement of living and learning options. The procedures we recommend are socially and culturally appropriate. The fit between our behavioral intervention supports and values of students, families, and educators must be contextually appropriate.

Our suggested behavioral intervention techniques are based upon a functional understanding of problem behavior. PBS and PBS plans are based on behavioral theory; problem behavior continues to occur, because the child getting something positive or escaping something negative consistently follows it.  A crucial tool in developing our behavioral intervention techniques and behavioral supports efforts is a Functional Behavioral Assessment (FBA); The FBA helps teams discover the antecedents, consequences, and frequency of challenging behavior. FBAs also help to identify any co-occurring variables.  Conducting FBAs doubles the success rate of an intervention.

FBAs lead to our understanding of the contexts and outcomes of the behavior, and helps determine the likely functions or maintaining variable of the behavior.  Using this information, we assist school teams in developing positive behavioral support plans and other behavioral intervention techniques in which the problem behavior less functional for the child, and functionally equivalent replacement responses (desired behavior), directly taught, are more functional and powerful for the student.  A collaborative effort among parents, school psychologists, teachers, counselors and administrators is facilitated to increase that PBS plans are implemented with high fidelity. Our interventions are individualized and tailored to the unique needs of any situation, as well as data based so that monitoring, evaluating and reassessing the process can occur fluently.

Functional assessment methods for Positive Behavioural Support 

Functional behavior assessment

Functional behavior assessment (FBA) emerged from applied behavior analysis. It is the first step in individual and cornerstone of a Positive Behavior Support plan. The assessment seeks to describe the behavior and environmental factors and setting events that predict the behavior in order to guide the development of effective support plans. Assessment lays the foundation of PBS. The assessment includes:

• a description of the problem behavior and its general setting of occurrence
• identification of events, times and situations that predict problem behavior
• identification of consequences that maintain behavior
• identification of the motivating function of behavior
• collection of direct observational data

• identification of alternative behavior that could replace the child's problem behavior (i.e., what a typical child does). Often this is measured through direct observation or standardized behavioral assessment instruments.

In some cases, the problem behavior identified in the functional behavior assessment is further analyzed by conducting a behavior chain analysis—in which the sequences of behavior that build up to the problem behavior become the focus.

The results of the assessment help in developing the individualized behavior support plan. This outlines procedures for teaching alternatives to the behavior problems, and redesign of the environment to make the problem behavior irrelevant, inefficient, and ineffective.

Another avenue of functional behavior assessment is growing in popularity—it is called behavior chain analysis. In behavior chain analysis, one looks at the progressive changes of behavior as they lead to problem behavior and then attempts to disrupt this sequence. Whereas FBA is concerned mostly with setting-antecedent-behavior-consequence relations, the behavior chain analysis looks at the progression of behavior, such as first the child may fidget, then he might begin to tease others, then he might start to throw things, and then finally hit another student.

Behavioral strategies available

There are many different behavioral strategies that PBS can use to encourage individuals to change their behavior. Some of these strategies are delivered through the consultation process to teachers. The strong part of functional behavior assessment is that it allows interventions to directly address the function (purpose) of a problem behavior. For example, a child who acts out for attention could receive attention for alternative behavior (contingency management) or the teacher could make an effort to increase the amount of attention throughout the day (satiation). Changes in setting events or antecedents are often preferred by PBS because contingency management often takes more effort. Another tactic especially when dealing with disruptive behavior is to use information from a behavior chain analysis to disrupt the behavioral problem early in the sequence to prevent disruption. Some of the most commonly used approaches are:

• Modifying the environment, antecedents (such as curriculum) to behavior, or routine

• Providing an alternative to the undesired behavior (not the same as a reward; it should be an alternative that is readily available to the person. The thought behind this is that the person may, over time, learn to more independently seek out appropriate options rather than the undesired behavior(s).)

• Tactical ignoring of the behavior

• Distracting the child

• Positive reinforcement for an appropriate behavior

• Changing expectations and demands placed upon the child

• Teaching the child new skills and behaviors

• Modification techniques such as desensitization and graded extinction

• Provide sensory based breaks to promote an optimal level of arousal and calming for increased use the replacement/alternative behavior

• Changing how people around the child react

• Time-out (child)
• Medication.

Behavior management program
The main keys to developing a behavior management program include:
• Identifying the specific behaviors to address

• Establishing the goal for change and the steps required to achieve it

• Procedures for recognizing and monitoring changed behavior

• Choosing the appropriate behavioral strategies that will be most effective.

Through the use of effective behavior management at a school-wide level, PBS programs offer an effective method to reduce school crime and violence. To prevent the most severe forms of problem behaviors, normal social behavior in these programs should be actively taught.

Consequential management/contingency management

Consequential management is a positive response to challenging behavior. It serves to give the person informed choice and an opportunity to learn. Consequences must be clearly related to the challenging behavior. For example, if a glass of water was thrown and the glass smashed, the consequence (restitution) would be for the person to clean up the mess and replace the glass. These sorts of consequences are consistent with normal social reinforcement contingencies.

Providing choices is very important and staff can set limits by giving alternatives that are related to a behavior they are seeking. It is important that the alternative is stated in a positive way and that words are used which convey that the person has a choice. For example:

• Coercive approach – "If you don't cut that out you'll have to leave the room."

• Positive approach – "You can watch TV quietly or leave the room."

Implementing Positive Behavior Support on a School-Wide Level

The current trend of positive behavior support (PBS) is to use behavioral techniques to achieve cognitive goals. The use of cognitive ideas becomes more apparent when PBS is used on a school-wide setting. A measurable goal for a school may be to reduce the level of violence, but a main goal might be to create a healthy, respectful, and safe learning, and teaching, environment.[26] PBS on a school-wide level is a system that can be used to create the "perfect" school, or at the very least a better school, particularly because before implementation it is necessary to develop a vision for what the school environment should look like in the future.

According to Horner et al. (2004), as cited in (Miller, Nickerson, & Jimerson, 2009), once a school decides to implement PBS, the following characteristics require addressing:

1. define 3 to 5 school-wide expectations for appropriate behavior;

2. actively teach the school-wide behavioral expectations to all students;

3. monitor and acknowledge students for engaging in behavioral expectations;

4. correct problem behaviors using a consistently administered continuum of behavioral consequences

5. gather and use information about student behavior to evaluate and guide decision making;

6. obtain leadership of school-wide practices from an administrator committed to providing adequate support and resources; and

7. procure district-level support.

If adequate support and consistency using a positive behavior support program exists, then over time a school’s atmosphere will change for the better. PBS is capable of creating positive changes so pronounced that alumni would mention the differences upon a visit to the school. Such a program is able to create a positive atmosphere and culture in almost any school, but the support, resources, and consistency in using the program overtime must be present.

School-wide Positive behavior support (SW-PBS) consists of a broad range of systematic and individualized strategies for achieving important social and learning outcomes while preventing problem behavior with all students.

Functional Behavioral Assessment

Functional Behavioral Assessment. Functional assessment is a process for determining the function of the child’s problem behavior. Functional Assessment or Functional Behavioral Assessment (FBA) involves the collection of data, observations, and information to develop a clear understanding of the relationship of events and circumstances that trigger and maintain problem behavior.

Functional behavioral assessment (FBA) is a process used to develop an understanding of a child’s challenging behavior (Carr et al., 1994; O’Neill et al., 1997; Hieneman et al., 1999). The goal of functional behavioral assessment is to identify the function of the child’s behavior—the reason or purpose why a child behaves as he/she does in specific situations. The process involves collecting information through the use of direct observations, interviews, record reviews(e.g., school and/or medical records, lesson plans, individualized education plans), and behavior rating scales. This information is used to understand patterns of the child’s challenging behavior—the ecological events or conditions that increase the likelihood of challenging behavior (i.e., setting events), what happens before the behavior occurs (i.e., triggers or antecedents), what the behavior looks like (i.e., the behavior), and what happens after the challenging behavior occurs (i.e., consequences). Once collected, the information is analyzed to determine the specific function or purpose of the challenging behavior—whether it occurs in order for the child to obtain something (e.g., attention, object, activity) or to escape something (e.g., demands, activities, social interactions) (Carr et al., 1994; O’Neill et al., 1997). The process is complete when there is enough information that will lead to the development of hypotheses or summary statements (Hieneman et al., 1999) that represent the behavior support team’s best guess or prediction as to what conditions reliably predict the occurrence of the child’s challenging behavior.

Observations

Observation, whether anecdotal or systematic, is the foundation of the functional behavior assessment process. In its simplest form, observation is a means of describing a child’s behavior at any given moment—what the behavior looks like and how often it occurs, as well as its length and intensity. Behavior can be observed either anecdotally or systematically. 

Anecdotal behavioral observations are informal in nature—they might include notes taken while observing a child’s performance during playtime, a parents’ recollection of his/her child’s behavior earlier in the day, scatter plots (i.e., charts used to record whether or not a child’s behavior occurred across activities, routines, or time periods), or antecedent-behavior-consequence analyses (Hieneman et al., 1999). In either case, there is no specific type of measurement procedure used to document the child’s behavior. 

In contrast, systematic behavioral observations are more structured and controlled—a trained observer would either physically sit in the same room and watch the child or use a videotape recorder to tape the child’s behavior.

Regardless of which type of behavior observation technique is used, it is critically important to conduct as many observations as possible so that the child’s behavior support team can be reasonably confident that the data obtained is both accurate and reflective of the child’s typical behavior. The rule of thumb is that unless the child’s behavior is dangerous to him/herself or others, the more observation data the better.

Antecedents
Antecedents are the conditions that immediately precede the occurrence of the child’s behavior (Cooper, Heron, & Heward, 1987; O’Neill et al., 1997; Hieneman et al., 1999). Antecedents include the specific times of day, settings, people, and activities that either occur or are present before the child exhibits challenging behavior. For example, if a 3-year-old child is found to have repeated tantrums whenever it is time to play at the water table, the direction to play at the water table might be an antecedent to the child’s challenging behavior.

Behavior
The term “behavior” refers to the child’s challenging behavior—what the child is doing (i.e., what it looks like), how often the behavior occurs, the length of the behavior’s occurrence, and the intensity of the behavior (e.g., the severity of a tantrum, the impact of the child’s striking hits another child) (O’Neill et al., 1997).

Consequences
Consequences refer to the events that immediately follow the occurrence of the child’s challenging behavior. Examples of consequences include the attention paid by an adult in response to the child’s behavior, as well as the activities and objects the child either escapes or has access to as the result of the behavior.

Setting Events
Setting events are ecological events or conditions (e.g. lack of sleep, change in routine, noisy environment, crowds, allergies, illness, etc.) that increase the likelihood that challenging behavior may occur (O’Neill et al., 1997). Setting events may continue to affect children's behavior even when an effective plan has been working for some time.
For example, Quan is a child who has asthma and a history of problem behavior. He has been learning how to wait his turn for the computer. The process for accessing the computer in his classroom is to put your name on the chart (by moving a laminated name to chart with Velcro) and wait until the child who is on the computer is finished (prompted by a timer). Once the child leaves, the next child moves their name to the computer space on the chart, sets the timer for 10 minutes, and begins working. Quan had a little difficulty with this process when first introduced to the class, but more recently has been able to follow those steps. On Monday morning, Quan comes to class with dark circles under his eyes. His mother tells the teacher that he was up most of the night with his asthma. When he decided he wanted a turn at the computer, he went over to the child who was sitting there and pushed him off of his chair. The child left and Quan sat down to use the computer. The setting event of being tired and not feeling well increased the likelihood that Quan would have problem behavior in this routine.
A team may decide to collect data on setting events and see if they have a relationship to the problem behavior. Those data collection forms are individually developed and tailored to the specific circumstance of the child and the team’s feeling about what distal factors may influence a child’s problem behavior.



Antecedent-Behavior-Consequence Analyses

Antecedent-behavior-consequence (A-B-C) analyses are used to determine patterns in the occurrence of the antecedents, behaviors, and consequences that relate to the problem behavior. A-B-C analyses are often quite useful in developing initial hypotheses or summary statements of the child’s challenging behavior.

In addition to A-B-C analyses, the team may use a data collection card to collect A-B-C information. Carr and his colleagues (1994) suggest using context cards - cards used to describe the general context, interpersonal context, behavior problem, and social reaction regarding the child's challenging behavior.

Context cards are helpful because they prompt the observer to consider the broader context that may relate to problem behavior. In addition, the collection of data on a car facilitates the easy analysis of the data. Once there are several completed cards, the observer or team member can sort the cards by perceived function of the behavior. This method of segmenting observations and collecting multiple observations is very easy for team members to use and understand. 

Interviews

The functional assessment interview offers an efficient method for getting information on the circumstances that relate to the child’s problem behavior. An interview is used to ask a family member or caregiver specific questions about the child’s challenging behavior, such as what the behavior looks like, when it occurs, and what happens before and after the behavior occurs. As with behavioral observations, as much interview information should be collected as possible—with the child’s parents, siblings, teachers, etc. Once collected, interview data is a useful tool for a team when attempting to identify patterns that may predict the function of the child’s challenging behavior.

The most popular and well-developed interview tool is the Functional Assessment Interview (FAI; O’Neill et al., 1997). The FAI is a comprehensive, semi-structured interview tool used to help carefully define the many variables that could potentially predict a child’s challenging behavior. The FAI begins with descriptions of the child’s behavior; helps define antecedents, consequences, and other important information; and concludes with hypotheses or summary statements (O’Neill et al., 1997). 

Behavior Rating Scales and Other Tools

In addition to direct observations, interviews, and records reviews (e.g., school and/or medical records, lesson plans, individualized education plans), behavior rating scales and other types of checklists offer an additional means of obtaining information about the context in which a child engages in challenging behavior. Broad in variety, behavior rating scales are questionnaires typically used to describe a specific set of behaviors (e.g., inattention, hyperactivity, social skills). Other rating scales are used to measure a child’s preferences, developmental milestones, academic performance/benchmarks, or medication side effects. 

Although behavior rating scales have many uses, they are most effective when used to compare the perceptions of people, such as parents, teachers, and other persons familiar with an individual child. Another effective use of behavior rating scales is to demonstrate progress toward goals (e.g., administering the same rating scale before and after an intervention is conducted). When used in either fashion, behavior rating scales provide a unique source of information that is potentially valuable to a team.

Function

One of the most helpful things to keep in mind in working with young children is the realization that each and every behavior has a purpose—an underlying reason for why it occurs. Once the function or purpose of a behavior is identified, it is then possible to design interventions directly targeting the underlying reason for why it occurs. 

Defined by context and pattern, functions of behavior are determined by understanding the events that occur before and after the behavior occurs—the patterns and chains of events that consistently occur when a child demonstrates challenging behavior. In most cases, the function of a child’s challenging behavior is either to obtain or get something or to escape or avoid something. 

Types of Behavior Functions
To avoid…
• Sensory Stimulation (pain and discomfort)
• Attention (adults and peers)
• Demands
• Tasks or activities
• People
• Activities
To obtain…
• Sensory stimulation (internal)

• Attention (adults and peers) 

• Objects and materials 

• People 

• Activities 

• Help

Functional Behavioral Assessment Checklist 

 Begin your direct observations and filling out the observation cards in your first meeting with the child.

 Complete the functional assessment interview form as one of the final assessment activities

 Review the information from the interview and your observation cards and then complete the final section of the functional assessment interview.

Develop your hypotheses from the information that you have gathered. There may be some hypotheses that you are unsure about. Collect additional information if you feel that the function is not clear to you.

Development and implementation of PBS Plans 

Behavior Support Plan Development

Behavior Support Plan Development – Once behavior hypotheses statements are developed to summarize the data gathered from the functional assessment process, the team can develop a behavior support plan. Essential components of the behavior support plan are prevention strategies, the instruction of replacement skills, new ways to respond to problem behavior, and lifestyle outcome goals.

The behavior support plan represents the culmination of the assessment process. Typically developed in connection with person-centered planning, the behavior support plan is the team’s action plan outlining the specific steps to be used to promote the child’s success and participation in daily activities and routines. In order to be most effective, behavior support plans should be both carefully developed and clearly written using plain language, incorporate the values of the family and support team, identify any prerequisite resources and training needs for implementation, and include individual components that are both easy to use and easy to remember. 

Behavior support plans must contain the following components: 

• Behavior Hypothesis Statements – statements that include a description of the behavior, triggers or antecedents for the behavior, maintaining consequences, and the purpose of the problem behavior.

• Prevention Strategies – Strategies that may be used to reduce the likelihood that the child will have problem behavior. These may include environmental arrangements, personal support, changes in activities, new ways to prompt a child, changes in expectations, etc. 

• Replacement Skills – Skills to teach that will replace the problem behavior.

• Consequence Strategies – Guidelines for how the adults will respond to problem behaviors in ways that will not maintain the behavior. In addition, this part of the plan may include positive reinforcement strategies for promoting the child’s use of new skills or appropriate behavior (this may also be included in prevention strategies)

• Long Term Strategies – This section of the plan may include long-term goals that will assist the child and family in meeting their vision of the child (e.g., develop friends, attend a community preschool program). 

Replacement Skills 

In the PBS process, challenging behavior is recognized as serving a purpose for the child. The identification of the purpose is the goal of the functional assessment process. Once the purpose of the behavior is determined (e.g., to escape or to obtain), an alternative means for achieving the same purpose of the behavior should be identified and taught to the child. On very few occasions, the purpose of the behavior cannot be honored (e.g., child screams and kicks to each car seat). When the purpose of the behavior cannot be honored, the behavior support plan may include different replacement skills that are not alternative skills to achieve the same function. For example, the support plan for a child who screams and kicks to escape the car seat could include strategies for teaching the child to select a toy and play while in his car seat. A replacement skill must be chosen that will be easy for the child to learn. Thus the team should look at the other means the child uses to communicate that are socially conventional and appropriate. For example, a child who has some natural gestures might be taught a gesture for “finished!” to escape an activity. What the team should not do is pick a replacement skills (e.g., raise hand and ask for a break), if it unlikely that the child can learn the skill quickly and easily. 

When selecting replacement skills, it is important to realize that the more efficient and effective the replacement skill, the more likely it will be used in favor of challenging behavior. The new skill should produce a positive effect as close to or as the same function as the challenging behavior, thus making the child’s challenging behavior less effective or useful. For example, if the child currently has tantrums in order to be picked up and cuddled by the parent, the child must have a way to gain the same results from the person he/she desires. One should realize that the challenging behavior may serve multiple functions for the child. For example, a child may head bang to end play demands and to request a drink. In that case, the child must be taught skills intentionally using planned procedures that will serve as replacement skills for each function—to communicate “finished,” as well as ways to mediate the demands and a request for a drink. 

Two other important considerations in the instruction of new skills are the efficiency of the replacement skill in comparison to the challenging behavior and the extent to which the replacement skills produce greater results for the child. If the use of the challenging behavior achieves an effect quickly, the replacement behavior must also achieve the same results and do so more efficiently. A critically important issue to consider regarding efficiency is that replacement skills must be easier for the child in some way—they should either require less effort to produce and/or should be easily understood by others. Likewise, rewards for engaging in the more appropriate replacement skill should be far greater than that which the child receives for exhibiting challenging behavior. When these conditions occur, the replacement skill will be more likely to increase and be more motivating for the child to learn and use than the challenging behaviors that were previously so effective. Regardless of which is selected, replacement skills must be relevant to the child's unique situation, abilities, and must be an immediately efficient mechanism for communicating wants and needs.

Finally, attention should be paid to the specific instruction procedures followed for teaching replacement skills. When teaching replacement skills, the child’s support team should select a skill to teach, identify a method of instruction, and systematically follow the steps required to implement that procedure. The keys here are consistency and repetition—the child should be taught replacement skills throughout the day whenever he/she is not engaging in challenging behavior using the exact same instruction procedures each time. An activity skills matrix offers an easy way to identify and plan for the instruction of the replacement skill. The matrix is used to identify opportunities where the replacement skill can be taught within a child’s routine activities and play. For example, if a child is learning to request attention by raising his arms to the adult for a hug (to replace screaming and pulling the adult’s hair), this skill can be taught throughout the day at home and at preschool. The child could be prompted to ask for a hug when coming in the classroom, ask fro a hug after making a selection during center time, ask fro a hug after clean-up, etc. The matrix form can be used to identify routines in the classroom where a new skill may be taught (preferably at times where the child is not having problem behavior) or routines at home where the parent can prompt the use of the new skill. A matrix is used by listing the skills to be taught across the top of the chart and the routines or activities down the side. The support team then looks at those activities or routines and identifies ways that the new skill can be taught. When these conditions are met, the potential for successful skill acquisition becomes greatly increased.

Prevention Strategies 

Prevention strategies include the responses that caregivers and professionals provide or the alterations that may be made to an environment that make challenging behavior irrelevant (Hieneman et al., 1999). For example, if a child has difficulty playing with an adult because he doesn’t understand turn taking, a prevention strategy may be to announce and signal turn taking to the child. Another example includes visual strategies used to inform a child who has difficulty with transitions that a transition is soon to follow. Making challenging behavior irrelevant typically involves changing the physical setting of an environment, enriching the environment, providing the child with more information or adaptive strategies, decreasing demands by adapting tasks or routines, increasing predictability, and providing choices to the child. These strategies alone will not resolve challenging behavior, but they will reduce the child’s need to use challenging behavior while the child is learning more socially-appropriate replacement skills. 

Consequence Strategies 

Consequence strategies are the responses to behavior used by caregivers and professionals when the child engages in challenging behavior. The most important features of consequence strategies are that selected procedures will make the challenging behavior ineffective and less useful and that rewards provided to the child for appropriate behavior will be either equal to or exceed rewards for engaging in challenging behavior. With respect to the latter, this feature is achieved in two different ways: 1) Reinforcement is provided to encourage the use of socially-appropriate replacement behaviors; and 2) reinforcement is withheld to ensure that the behavior won’t work for the child (i.e., result in reinforcement). The most commons strategy that is used in response to a young child’s challenging behavior is to redirect the child to use the replacement behavior and then follow with reinforcement. When that occurs, the child still gets their needs met and has a reminder that the replacement skill is the behavior to use to gain access or to escape an activity, object, or interaction.

Safety Net Procedures
Whenever a team works together to help support a child with challenging behavior, the first concern of the team should always be safety. This is of particular concern with children who have a history of dangerous outbursts or behaviors that may place them directly in danger (e.g., running away)—any specific procedures that should be followed whenever the child engages in any challenging behavior that potentially places either the child or any other person in danger (Hieneman et al., 1999).
If a child has a history of dangerous behavior that places the child or other in harm, safety net procedures should be developed and included in the behavior support plan. Safety net procedures provide a script for what adults will do when the child engages in behavior that is potentially dangerous. Safety net procedures are strategies that keep children safe, they do not change behavior. In the past, strategies that are safety net procedures have been used by interventionists (e.g., removing the child from the room) as the sole intervention approach. These procedures only serve the purpose of ensuring the safety of the child and others. If a team develops or uses safety net procedures with a child, a full behavior support plan should also be developed and implemented.
Plan Development
The support plan is developed to provide caregivers and interventionists with a comprehensive set of strategies aimed at both decreasing occurrences of challenging behavior and promoting growth and skill development (e.g., communication, adaptive, social, or academic skills). Support plans are developed by analyzing the child’s challenging behavior in routines, activities, and/or interactions with others (i.e., functional assessment data).

It is important that the entire team is involved in the development of the behavior support plan. If team members assist in the development of the plan, they are far more likely to be invested in its implementation and success. One method that might be used by the team to develop a plan is to use a process of brainstorming. We use chart paper and the following format to guide the team in moving from the behavior hypothesis to ideas about prevention strategies, new skills to teach, and consequence strategies. In a brainstorming process, all team members are encouraged to share their ideas. All ideas are put on the chart paper. Once the ideas are listed, the team discusses the strategies that seem to have the most promise, will be easy to implement, and fit within the contexts for intervention. The final step needed to move from brainstorming to plan development is to review the ideas and select the set of strategies that will be used in the plan. Once those are determined, a written plan can be developed. 

The most effective behavior support plans are ones that are both based on the functional assessment information and “fit” with the lifestyles, values, and skills of caregivers who will be implementing the plan. Behavior support plans should be written in language that is easy to understand, and both easy to use and remember. More importantly, plans should incorporate both long- and short-term support strategies developed from knowledge of the child’s lifestyle and the vision created for the child in the person-centered planning meeting. What this means is that plans need to be designed for daily use—that is, components must fit into the child’s natural routines and structure of the classroom or family. 

Action Plans 

Once each of the behavior support plan components has been developed and agreed upon by team members, the final step is to develop an action plan outlining the specific objectives and corresponding steps to be taken to ensure the plan will be implemented as intended. Completing the action plan is largely an exercise of organization—one where the team specifies its needs, the specific steps to be taken, the person(s) responsible for completing the steps, the anticipated date of completion, and any follow-up actions to be taken in order to accurately implement the team’s behavior support plan (Hieneman et al., 1999). Once complete, the team is ready to begin implementation of their plan. 

Behavior Support Plans 

Once the action planning forms are completed and a crisis management plan is developed, the behavior support plan should be finished. While the outcomes associated with the implementation of the plan will still need to be monitored, this stage of the PBS process is concluded.