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| Enhancing the Direct Care Professional's Ability to Implement Effective Behavior Supports |
| Sunday, May 29, 2005 |
| 1:30 PM–2:50 PM |
| Stevens 1 (Lower Level) |
| Area: DDA; Domain: Service Delivery |
| Chair: Richard W. Powell (Shelby Residential & Vocational Services) |
| CE Instructor: John J. Pokrzywinski, M.A. |
| Abstract: The papers in this symposium examine positive behavior support procedures that emphasize identifying and manipulating contextual or antecedent variables related to problem behaviors in individuals with developmental disabilities. Variables examined include staff and supervisor training, the role of choice making, setting events and discriminative stimuli, and the inclusion of direct support staff in the development and implementation of positive behavior support plans. The effects of these different strategies are examined and discussed in terms of changes in the trends of problem behaviors, changes in staff behavior, and changes in the acceptability of behavior support plans. |
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| Using Feedback to Improve Direct Support Staff and Supervisor Performance |
| IRFA KARMALI (Shelby Residential & Vocational Services), Richard W. Powell (Shelby Residential & Vocational Services), John J. Pokrzywinski (Arlington Developmental Center) |
| Abstract: A supervisor’s primary job is to make sure that the quality of staff performance is at a level satisfactory to provide the support needed by agency consumers. When staff work is not up to par, it is the supervisor’s job to ensure that performance rises to adequate criteria. When the staffs’ performance is good, a supervisor’s job is to see that the staff continues to do a good quality work. Selected training modules from a standardized positive behavior support curriculum were used to teach supervisors three basic supervisory skills. Supervisors were taught to describe four guidelines for obtaining information about staff performance, and how to conduct an observation in a manner likely to be acceptable to direct support staff. Next, supervisors were trained on the use of performance checklists for observing job duty in the work environment. Finally, supervisors were trained to use verbal and written feedback as a practical and effective means of training and motivating direct support staff. This included a seven-step feedback protocol. The effects of these interventions are discussed by examining changes in target behavior trends, and changes in staff performance. Direct support staff performance was assessed by changes in individualized performance checklists, absenteeism, and agency performance evaluations. Supervisors were also rated for changes in the ability to conduct observations, complete performance checklists, and provide effective feedback. |
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| Identifying Contextual Variables to Improve Preventative Procedures in Behavior Support Plans |
| JOHN J. POKRZYWINSKI (Arlington Developmental Center), Richard W. Powell (Shelby Residential & Vocational Services), Irfa Karmali (Shelby Residential & Vocational Services), Tandra S. Hicks (Shelby Residential & Vocational Services) |
| Abstract: The purpose of the contextual assessment is to identify situations that are likely to lead to problem behavior. There are two types of factors that increase the chances of problem behavior: setting events and discriminative stimuli. Contextual assessment refers to focusing on whole events and facilitating understanding a person’s behavior within a historical and situational context. Sensitivity to the role of context in understanding the nature and function of an event focuses on the implicit consequences of an on-going action. A firm grasp on a pragmatic truth criterion focuses on what works and what does not work. Applied behavior analysis strategies usually consist of: setting event strategies, predictor strategies, teaching strategies, and consequence strategies. This study examines the first two strategies as potential antecedent preventive procedures. These antecedents are setting events, establishing operations, discriminative stimuli, and discriminative punishers. Potential ecological/setting events examined included: medications, medical or physical problems, sleep cycles, eating routines and diet, daily schedule, numbers of people, and staffing patterns and interactions. Immediate antecedents events examined included: time of day; physical setting; behaviors that occur more consistently in the presence of particular people; and specific activities related to problem behaviors. |
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| Using Enhanced Direct Support Participation to Increase the Proficient Implementation and Integrity of Behavior Support Plans |
| ANGELIQUE DILWORTH (Shelby Residential & Vocational Services), Richard W. Powell (Shelby Residential & Vocational Services), Irfa Karmali (Shelby Residential & Vocational Services), John J. Pokrzywinski (Arlington Developmental Center) |
| Abstract: Current systems theory looks at methods to increase the proficiency with which direct support professionals implement and carry out behavior support plans. One frequently recommended technique is to involve these staff in the planning and development of positive behavior support interventions. Little data, however, has been presented evaluating this technique. The purpose of this study is to investigate how involving staff in the planning of the behavior support plan improves the proficient implementation and integrity of the procedures. During this study direct support professionals attended planning sessions to construct a behavior support plan for an individual under their care. The staff participating received standard training and had worked with their person for at least six months before being involved in this process. During the baseline weekly data and treatment reliability/implementation checks were conducted. Also, monthly follow up sessions were conducted to discuss changes in behavior. Prior to and at the completion of the study, staff members were asked to complete several assessments scoring plan acceptability. Their ratings and implementation data were be compared with similar staff members who supervise similar individuals who had not had this experience. |
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| Teaching Staff to Neutralize Problem Behaviors Through Identifying and Increasing Choice-Making Opportunities |
| TANDRA S. HICKS (Shelby Residential & Vocational Services), Irfa Karmali (Shelby Residential & Vocational Services), Richard W. Powell (Shelby Residential & Vocational Services), John J. Pokrzywinski (Arlington Developmental Center) |
| Abstract: Many adults with developmental disabilities are rarely allowed to make reasonable choices about everyday issues such as what to wear, what to do during free time, whom to sit with, what time to go to bed, etc. The consequences of limiting choices lead to protests in inappropriate ways when his or her preferences are not reflected in these decisions. Such aberrant behaviors are observed primarily in individuals whose communication skills are extremely limited. Among a series of behaviors, non-compliance being the least severe response to a series of inevitable events, could be avoided by encouraging the individual to make choices that reflect his or her preferences and what happens to him or her on a daily basis. Checklists were used to assess the opportunities that individuals had to make to make choices in their daily routine. Additionally, the individuals’ current behavior plans were assessed to identify whether choices were part of the plan. If choices were not an identified objective in the behavior plan, an addendum was developed to add the additional objective for the purpose of measuring outcomes for this study. Using a component of a standardized positive behavior support curriculum, direct support staff members were then trained to: identify the importance of making choice for enjoying life; demonstrate how to provide a choice to individuals who do talk; identify when to give choices; and identify positive outcomes of giving choices. The effects of these interventions are discussed by analyzing the results of the data collected on target behaviors, changes in choice making opportunities, and changes in ratings of behavior support plan acceptability. |
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