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Education
and
Effects of a Positive
Communicative
in Developmental
Division
Training
Support
Disabilities,
on
2003,
95-105
38(1),
Disabilities
Developmental
to Enhance
Approach
effects of a positive
intervention
Tali
Roth
by an augmentative
support plan accompanied
on the reduction of challenging
behaviors manifested by
was used for
children with moderate and severe mental retardation. A multiple-probe design across participants
data
on
various
behaviors
exhibited
students
behaviors,
including:
self-injurious
collecting
challenging
by
assessment, followed by
pinching, pulling, screaming, and crying. All behaviors were assessed using functional
a positive AAC support plan created by the school team. Participants
were taught to use more appropriate
and
and
of Haifa
alternative
alternative
means to communicate.
Results indicated a reduction in the percentage of intervals of challenging
communicative
The positive support plans created by the whole school staff used AAC for enhancing
This plan provided students with alternatives,
which also enabled them to enhance the learning of
behaviors.
behaviors.
class
material.
difficulties
Communication
with
disabilities
developmental
foos,
Pennel,
behaviors
include
may
tantrums,
and
self-injury,
erty. These
behaviors
aggression,
destruction
may appear
remain
stages and
developmental
the school
years (Sigafoos,
can be
of these behaviors
vidual's
and
These
challenges
present
ing the classroom
between
errant
difficulties
the
behaviors
Horner
& Day,
(e.g.,
that
supportrelation
have
the existence
& Durand,
A recent
1991).
revealed
developbehaviors
a strong
Carr
many
early
of positive
classa consequence,
children
and
communication
(Mirenda,
five
the indi-
personnel
(Sigafoos).
have
found
Researchers
the
or challenging
behaviors
func
of functional
and
analysis
as the primary
tional communication
training
behaviors
to reduce
strategy
inappropriate
review
interventions
with
Education,
Haifa,
Mount
Faculty
Carmel,
of
Education,
Haifa,
were
strategies
use
31905,
of
messages
depicting
behaviors.
For
appropriate
ing
(AAC)
the intervention
during
Some
of these
strategies
with
switches
accompanied
symbols
with
augmenta
in
replaced
switch
a
example,
that
a repeated
was used for attract
message
with
attention
of an adult
by a toddler
behaviors
aggressive
demonstrates
search
were
behaviors
(Peck
assessed
and
intervention
munication
demonstrated
fewer
their
Re
1996).
inappropriate
corn
a functional
was applied,
children
behaviors
challenging
communicative
behaviors
ad
1985;
(e.g.,
of re-
& Hearthfield,
O Brien,
1990).
Sprague,
includes
a system
intervention
Functional
re-
increased
et al.,
that when
of ab-
should
Special
of
University
Israel.
studies,
communication
used
(Mirenda).
process
included
Carr
& Durand;
atic assessment
this article
Correspondence
concerning
to Orit E. Hetzroni,
addressed
Ph.D.,
In some
1997).
alternative
and
E-mail:
a%
Positive
of the function
& Day;
Horner,
of the problem
followed
equivalent
Durand
sessment
Hetzroni@construct.haifa.ac.il.
Horner
proce
by an intervention
the inappropriate
dure intended
to substitute
.'.
.
...
,
, ,
and function
behavtors
with more acceptable
behaviors
be
aberrant
use
included
of prop-
throughout
The impact
to impede
to
lating
extreme
during
2000).
learning
progress
of social
relationships.
ment
their
individuals
place
at risk for de-
behavior
(Sigasignificant
problems
& Graves,
1999).
Challenging
veloping
search
behavior
(AAC)
AAC Support
ones.
(1985),
In the study
for example,
evaluated
for Reducing
the
by Carr
communicative
Challenging
and
as
a systematic
Behaviors
func
95
of four
tions
who
with mental
students
in significant
engaged
behav-
municative
destruciors including
self-injury and property
tion. Once
the functional
was comanalysis
and
the communicative
function
was
pleted
identified
adult
(i.e.,
attention
seeking),
was implemented
intervention
with posto replace
the challenging
behaviors
itive communicative
(Carr & Durand).
phrases
communication
use
The
of challenging
and
tigate
treat
McDowell,
that
These
1992).
served
as
the messages,
were
childhood
(Sigafoos,
individuals
with
Providing
transmit
possibly
2000).
in new,
to inves-
strategies
means
to
inappropriate
most
efficient
the
in early
engage
attenin sev-
behaviors
&
(Carr
problem
Hall & Belfiore,
1997; Taylor
1980;
& Carr,
as an
behavior
tion-getting
eral studies
learned
to
opportunities
and more
efficient,
more
apis an ef
means
to obtain
attention
propriate
fective
for reducing
bestrategy
challenging
haviors.
the need
to use elaborate
However,
measures
to analyze
the functions
of the be
the need
to follow rigorous
pro
used
to eliminate
behaviors
previous
cedures
Bamburg,
Positive
behavior
Cherry,
(Mat-
&
1999).
Paclawskyj,
has the potential
for
for altering
behaviors
man-
communication
inappropriate
ifested
with mental
by children
retardation
& Horner,
1999).
(Sugai,
Sprague,
Positive
behavior
is defined
as
support
for reducing
behavior
approach
problems
sociated
with deficits
Positive
behavior
ior.
After
iors
and
an
as-
the environment.
uses
support
to identify the function
sessment
functional
as-
of the behav-
the challenging
behavidentifying
their
a
functionality,
systematic
is created
to assist the enviplan
instruction
ronment
(i.e.,
in
staff)
within
teachers
providing
substitute
students
and
positive
other
support
support
to help
behaviors
inappropriate
that are appropriate
1997).
(Weigle,
is based
on team activities
that
approach
with ones
This
evaluate
the
intervention
plan.
The
curs
within
behaviors
using
positive
and
a positive
behavior
plan a systematic
behavior
support
support
plan oc-
a long-term
lifeplan using broad
style intervention.
This study was designed
to use the positive
96
Education
and Training
in Developmental
mental
ers and
staff with
goal
to develop
intervention
team
se
teach
pro
The
classroom.
with tools
assessment
and
to
plan,
own classrooms.
their
to provide
intervention
the school
the functional
and
moderate
and
a positive
within the
applicable
was to provide
within
with
retardation,
cedure
and
the
them
implement
The intervention
AAC
applied
strategies
using voice
devices
with
recorded
output
accompanied
and appropriate
messages
symbols
depicting
the substitute
The
of this
messages.
purpose
strategies
effects of training
teach
Study was to examine
ers and the school
team to identify and use a
AAC
chal
positive
system to replace
support
behaviors
lenging
cative behaviors
ate
and
severe
with appropriate
students
among
mental
retardation,
communi
with
moder
Method
Children
be-
support
a systematic
framework
providing
by children
exhibited
vere
Participants
and
haviors,
com
to identify
support
approach
functions
of challenging
behaviors
behavior
retardation
challenging
with
mental
retardation
lected
to participate
in the study
the following
criteria:
(a) formal
moderate
or
severe
mental
were
se
to
according
of
diagnosis
retardation,
(b)
between
formal
mental
cated
(with
in a medium
mental
size
dren
attended
prior
to this intervention,
a
the
patholo
participants
with moder
some
children
retardation)
city in Israel.
school
14-year-old
boy,
mental
retardation,
was
diagnostic
observation,
for children
with severe
Larry,
moderate
direct
speech-language
teachers.
All
retardation
diagnosed
information
clinical
records,
with
verbaliza
and/or
gestures
Selection
for
several
diagnosed
All
lo
chil
years
with
used
and
touching
and
rejecting
for requesting
and
gestures
to use only a few one- or two-word
utterances.
He
manifested
behaviors
usually
was
able
such
as
down,
peers,
and
diagnosed
Disabilities-March
a staff member,
his
pulling
classroom
biting
a 12-year-old
Hank,
screaming.
boy,
with moderate
mental
retardation,
tugging
pants
pulling
and
2003
with
no
disabilities,
physical
and
vocalization
to
tures
and
questing
behaviors
and
such
the
hair
boy,
was
pulling
16-year-old
mental
He
rejecting.
as pushing,
retardation
used
indicate
mosdy
basic
gesre-
usually
manifested
usually
with severe
diagnosed
and
cri-du-chat syndrome
aggressive
items,
throwing
including
away
running
pushing
from the
a list of challenging
the
they
time
lasted;
and,
behaviors
and
a procedures
(e)
form.
pinching,
spitting,
of peers
and staff. Al, a
and
com
output
and
16 mes
with picture
communica
used for augmenting
interven
participants'communication
during
sages)
accompanied
tion symbols
(PCS)
He
used
vocalization,
("cat-cry").
pointing,
and only a few one- or two word utterances
to
indicate
and rejection.
His behaviors
requests
were
included
were
tion.
Design
class
and
that typibehaviors
room,
self-injurious
cally included
lying on the floor while banging
his head.
a 19-year-old
Dan,
boy, diagnosed
with
in which
as percentage
of intervals
the chal
behaviors
occurred.
Data
collection
lenging
moderate
mental
retardation
and
Down
used
such as pointing
to
syndrome,
gestures
and
indicate
manifested
behaviors
requests,
such crying, laughing,
passivity, and ignoring.
boy,
Jo, also a 19-year-old
vere
mental
retardation,
with
diagnosed
used
se-
vocalization,
and
a few oneor two-word
utterpointing
anees
and rejecting.
for requesting
Jo's chaiin school
behaviors
included:
sitting
lenging
on the floor while banging
his head,
screamon
jumping
of paper.
pieces
and
chairs,
ing,
manipulating
across
was
multiple
probe
design
subjects
& LeSage,
used
1982; Poling, Methot,
(Kazdin,
The dependent
variable
was calculated
1995).
was
based
on
a direct
observation
behaviors.
challenging
Specific
of:
corded
included
instances
of
(a)
re
screaming,
(e)
kicking,
(f) lying on the floor, (g)
destroying
property,
lying on the floor and hitting head on ground,
(b)
pushing,
(h)
sitting
(c)
checklist
behaviors
on
(d)
pinching,
the
floor
and
on
(i) jumping
ground,
hair, and (k) all other
head
hitting
furniture,
behaviors.
on
(j) pulling
Observations
once
a day, three
times
a
for 20 min
30-second
intervals,
using
A positive AAC support
utes each session.
plan
. ,
,
,
team was the mde
the
classroom
compiled
by
this
variable
Table
(see
1). Using
pendent
were
conducted
week,
_
. ,
...
Setting and Materials
All
students
rooms
(Larry,
Dan and Jo were
had
participant
with
materials
Each
schedule.
with
students
Several
during
in
worked
approach,
in another
analyses
function
an
were
communicative
culties;
to
(b)
record
(c)
attended
the
abilities,
and
level
tion,
a
to
of abilities,
behavioral
information
formation,
(a)
form used
information
form
a direct
observation
form
Prior
lectures
used
to
record
antecedents,
consequences
responses,
and their length
of all challenging
behaviors,
that
checklist
of time; (d) a direct observation
Positive
the team
determined,
behavior
the
Once
identified
for the
substitute
was
challeng
created
as a
mes
communicative
were
messages
to gain attention,
to acquire
used
in
to express
rejec
requests.
and
of
determining
behaviors,
AAC Support
and
use
behaviors,
functional
functions
were
for Reducing
about
communication
Teach
support.
na
to the communicative
and
the
in
behavior
challenging
assessment
staff was
program
for teaching
alternative
positive
introduced
ers were
tional
simulations
and
entire
that included
in a school-wide
augmentative
and
(AAC)
ture
the
to intervention
used
challenging
of the varthe description
ocbehaviors
in which
those
behavior.
,
n
JrT0C6CLUT6
volved
and
functional
conducted
child's
each
or to indicate
diffi-
behaviors,
activities,
was
The
sages.
classroom
instruction
for specific
team
This
ing behavior.
means
to transmit
or eight
assistant.
one
the
to assess
a communicative
stacked
classroom
seven
and
information,
a general
staff responses,
ious situations
curred;
had
created
personal
desk
for the
teacher
Each
classroom).
individual
appropriate
classroom
one
participant
record
personal
class-
respective
schedules
regular
while
Al in one classroom
professionals
the school
day
periods.
Five forms
their
their
following
Hank
and
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Challenging
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dents
functional
skills
for replacing
challengreinproviding
positive
of instruction,
teachers
while
ing behaviors
forcements.
As part
were
asked
to bring students'
and school
programs
cation
the preliminary
Following
school
staff (i.e., teacher,
assis-
section).
with
meeting
tant teacher,
counselor,
speech
and
therapist,
thologist,
physical
a functional
therapist),
was implemented
(see
to baseline
language
pa-
forms
sessions
team
in
information
communication
during
the school
team
classroom
regular
setting
with the stuteam working
the prosessions
implementing
were
enrolled
enrolled
data
enrolled
Larry,
classroom
in
in classroom
collection
Hank,
and
and
Al
were
Jo
observations
were
Dan
were
procedures
observers
two
in two differ-
1.
2. All
the
classroom's
collected
data
teachers
in the
forms
daily
by
to the
came
procedures
and
classroom
for procedural
measures
three
participants
regular
during
iors were
(see
form
times
measured
d in Setting
Once
a clear
room
staff met
used
a week
the
baseline
All behavform
checklist
classand
es-
findings
intervena systematic
positive
support
appropriate
plan using AAC to enhance
tablish
tion
functional
classroom
from
classroom
respective
The
communication.
from
1 (Larry)
2 (Dan)
staff. During
and
were
for
classroom
included
a
Appropriate
child
to
each
activities
Table
(see
messages
use
during
1).
Messages
recorded
on
voice
the
first
the meeting,
child
first child
assessed
with
messages
the
assistance
of
the
child's
mem
the
the meeting,
was used
During
role-playing
to practice
the intervention
with the staff, to
all team members
teach
how to use the de
and
to practice
how to introduce
uses
with
the participant.
messages
staff
learned
to recognize
ing practice,
vices,
first indicators
the
by the
a positive
Positive
of the communicative
for each
typical
tional
child
assessment
student
appropriately.
tified before
the
the
the
to use
the
the VOCA's
toward
verbal
the appropriate
rein
to the
a proce
with 3 sec
with
prompt
to use
a
the
gesture
on the switch;
message
the verbal
physical
prompt
a gesture;
and,
(d) full physical
hand
to
the participant's
leading
was
used
the message
last
(the
prompt
a partial
and
prompt
(c)
guidance
activate
only once
twice with
with
with
and
the
three
of the
participants
and
the assessment
ter
two of them).
Intervention
and
natural
ap
in
students
immediately
included
by responding
Assistance
message.
switch;
func
to assist
for communicat
used
forcement
ond
how
behaviors
challenging
staff assisted
learning
ing with
dure
the
function
in using
the substitute
messages
were iden
The first indicators
and
child's
Dur
to the
according
learned
and
peared,
minated
section).
established,
the
to refine
the
Materials
was
the
for 20 minutes
activities.
using
and
also
by
out
filled
integrity.
were obtained
classroom
were
based
Observers
plan.
on
Baseline
and
conducted
who
independent
Times
school
scheduled
times.
during
the day
selected
randomly
throughout
on
children.
created
and
the
gram. Participants
ent classrooms.
of those
All team
speech-language
pathologist.
bers were responsible
for implementing
intervention
with the child,
and
ment
were
Interviews
created
(VOCA)
to gain
meeting
and
was
established.
plan
Messages
based
on the functional
assess
were
sage/s.
in the classroom
discussed,
were
pants
munication
procedure
b and c in Set-
was planned.
Challenging
by the first two partici
evaluated
and
a functional
corn
support
system
behaviors
exhibited
occupational
assessment
Materials
section).
ting and
observations
were conducted
prior
about
edu-
concernreports
of students
in
patterns
form a in Setting
and
ing communication
their classroom
(see
Materials
individual
AAC
once
began
the team
agreed
communication
(see
plan
Table
in using
were
Students
on the messages
1).
the
de
independent
was used to intro
hierarchy
prompt
to the first pair of
duce
the new messages
needed
and
was used
students
only when
vices.
The
were
(prompts
1-2 sessions).
ted,
the
AAC Support
needed
Once
only
the message
staff responded
for Reducing
was
first
transmit
immediately
Challenging
the
during
Behaviors
to the
99
the
by the student
activating
in baseline,
all challenging
behavas inappropriate
(identified
messages)
voiced
message
device.
iors
were
Data were
ignored.
intervention
sessions.
Criterion
30%
three
33%,
As
was
collected
and
of challenging
sessions
(20%
behaviors
for Dan,
for
of his challenging
behavwas met for the first pair
a meeting
was set to evaluate
functions
of the
messages
Once
analysis.
ing analyzed
ments, and
criterion
the third
the third
sessions
low-up
after ending
six weeks
each
child's
was met,
second
second
set of functional
intervention
were
the intervention
after
and
message,
Two
again
familiar
no
he
initiation,
re
reverted
behaviors.
to his initiations,
response
decreased.
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students)
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trained
to collect
data using the direct obser.
c
.,
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vation forms. One observer
collected
data dur.
.
. ,
, ..
, ,
while the second
observed
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ing all sessions
.
,
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nr.r
r ,
classrooms
tor 20%
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randomly
.
.
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r
tor mterobserver
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agreement
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.
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the overall
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dividing
by'
.
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,
r
,
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, r
...
r>
i
i
100.
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ments,
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for the percentage
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i oyifw r
u u
and
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identification
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j
r n
i
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r .
dures
were
followed
of the
92%
accurately
and
the
behaviors
Data
of all procedures
recording
that
the response
re
procedure
consistent
for the
three
students.
mained
Agreement
Those
results
low-up
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remained
steady
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fol
,
2 presents
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figure
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00
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behaviors
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levels
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haviors
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.
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for the
.
.
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level of change
obtained
were 22%
for Dan
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x
r
behaviors
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.
.
.
J,
intervention
was
Results
re
implemented.
r
.....
,
mained
similar
the follow-up
sessions
during
that
took
cording
Results
the
the
During
detected
Larry
switch
to
of chal
session.
observers
level
by Larry were
in responses
not
messages.
once
15%.
performance
at first. The
refreshing
indicated
Interobserver
his
immediately
assess-
then
to
sponse
meet-
Folbegan.
one
week
conducted
to Larry's
and
ately
and
the
starting
immedi
respond
After activating
the
staff did
intervention,
functional
a team
at 6%
made
of participants,
to select
the appropriate
and to begin
intervention.
As with
messages,
the first participants,
the team
the
selected
on
intervention
consistent
pair
based
after
of behaviors
and
inconsistency
behaviors
demonstrated
lenging
to the passive
nature
criterion
iors). Once
of participants,
the communicative
at
challenging
but only after 5 sessions,
while for Hank
were faster and stabilized
im
Al, changes
stabilized
Changes
demonstrating
Larry's
were
and
inconsistent
gradual
due
that for
indicated
behavior
mediately
of at least
set as a reduction
in frequency
consecutive
all
during
Results
39%.
the
Larry,
13%,
and
41%,
place
of the
several
months
later.
indicated
procedures
Data
re
that
the
Results
for the
participants
ure 1 indicate
haviors
All
multiple
for classroom
for each
participant
participants
in the amount
demonstrated
tion
was
behaviors
tively.
across
in Figof challenging
beacross all sessions.
demonstrated
a reduc-
of challenging
behaviors
in the classroom
after intervenLevels
implemented.
baseline
during
for Larry,
Reductions
for
>, and
100
percentage
three
tion
probe
design
1 presented
54%
Education
of challenging
were 36%,
sessions
Hank,
these
and Training
and
Al, respecstudents
were
in Developmental
sistent
interactions
with
time
peers,
ademic
on
task,
and
All
ac
used
performance.
participants
their messages
for all activities
the
throughout
school
Teachers
recorded
day.
changes
the school
all aca
throughout
day during
demic
and
changes
served:
Disabilities-March
social
activities.
After
in other
students'
behaviors
the behaviors
changed
2003
intervention,
and
were
ob
the partic
Baseline
~lI
1I
Intervention
/A
1r~
Larry
Follow-up
~iiir~
ii
1r
Hank
-i
1ii
1i 1i
rii
T+
~i
Al
11
Figure
1. Percentage
13
15
and
more
19
21
Number of Sessions
of challenging
academic
on
the
Positive
moderate
and
intervention
demonstrated
results
iors and
AAC Support
behaviors
support
the functions
for Reducing
severe
exposed
33
to the
to
as they learned
devices.
plan
mental
decreases
noticeable
communication
AAC
r~
31
manifested
behaviors
challenging
their
1ii
29
and Al.
retardation.
positive
The
27
with
use
r*-!i
25
by children
n their challenging
1i
23
behaviors
AAC
behaviors
their
decreased
aggressive
ipants
initiwith their class peers;
began
participants
more
in social
behaviors;
ating and engaging
time on task was apparent
were recorded.
behaviors
17
Use
provided
regardless
of the
effective
of their behav
they served.
Challenging
Behaviors
101
Intervention
Baseline
Follow-up
Dan
Jo
As
in
Table
and
the
presented
1, the
communica-
devices
used
varied
messages
after inthe five participants.
However,
tervention
became
consistent
and
the staffs
across
was
all
response
steady,
their
inappropriate
tir strategy used.
switch to indicate
him.
When
he
needed
for him
material
the switch
to call
edgment
her.
sions.
the
of
his
to come
teacher
to
to
activity, he
this goal
Achieving
along
add
used
with
and
the procedures
some
during
As a result, Larry's challenging
At
did
not
of the sesbehavior
returned
the
new
sult
in the desired
communicative
understand
102
the
Education
effect.
direct
messages
It took
relation
and Training
did
not
staff time
between
27
25
31
29
33
and Jo.
behavior.
Larry's
to be consistent
to his
sponded
means
When
and
used
Larry
request,
transmit
his
staff's
they re
his new
for getting
messages
as they were proved
to be both ef
and efficient.
These
results are consis
to
fective
that found
research
previous
their goal using
students
achieved
in an effective
and
efficient
behaviors
tent
replace
Hank
the
tance
was
it was
efficient
desired
that
He
tent
attention
The
Disabilities-March
with
"I
effective,
recognition
in
engaged
will
and
go
no
times,
on
approval
interruptions
2003
only
did it
from
on-task
careful
through
at critical
to him
to use,
easy
or
assis
how
working"
from
staff participated
in the
to the statement
and
reaction
worked
frequent
he was
learned,
provided
the sentence
regain
teacher.
and
also
consistendy
the previous
behavior,
teacher
of
to
their
way,
to adopt
the new and appropriate
they tended
behaviors
1980; Hor
(e.g., Carr & McDowell,
ner & Day, 1991).
More
so, even if the new
use
re-
that
with
when
as
their
in Developmental
started
behaviors.
to his
appeared
immediately.
Larry
old patterns
of attention
as soon
seeking
there was no response
and the indication
and
response
behavior
when
initiated.
inconsistent
for Dan
behaviors
behavior
communicative
appropriate
time
they were
23
21
attention,
of using
demonstration
with consistent
acknowl-
each
attempts,
staff was
first, school
follow
teacher
to resume
result
his
reduced
participants
behaviors
regardless
For example,
Larry used
to the
17
15
19
Number of Sessions
of challenging
2. Percentage
Figure
tion
13
11
to
to
the
consis
Hank
inappropri
ate
behaviors.
sistent
With
of the
the
Hank,
at all times.
team
was
an informal
During
con-
review
team's
response
type, they indicated
the need
for consistency
observing
to remain
conLarry, they were careful
that
after
with
sistent
with
other
They indicated
eralized
to the
ture
research
effects
students
that
in
towards
should
the other
Al's
desire
classroom.
this consistency
also
classroom
students.
other
look
genFu-
at the
generalized
method
of inter-
of using
a preferred
with one
student
vention
the
on the responses
in the classroom.
students
the room
for specific
by using a single switch
and a communication
chart with a few symbols. The symbols provided
the possible
places
reasons
to leave
was addressed
he
wanted
usually
room
the
(i.e.,
the
stroom,
and
switch
destination
trams.
to select
when
he
office,
principal's
office).
secretary's
the symbols
to indicate
in a reduction
resulted
Previous
research
the
in
their
his
passivity
changed
and crying
behavior
to active
activities
using
initiating
on it. Once
several messages
his VOCA
he began
members
the
Using
his desired
in
tan-
use
of
challenging
and
the several
he learned
the
ous
positive
screaming
inappropriate
All these behaviors
behaviors.
effective
and
efficient
other
to
tent responding.
occurred
Changes
the
throughout
were responsible
across
ac-
all
change
account
of atmosphere
for consistent
time
not
activities
school
Positive
the children
rather
results,
than
an
although
could
recorded,
signify the
classroom
and
in the
use
2000).
(Sigafoos,
students
behaviors,
behavior
during
school
messages
to
activities,
and
tion
to all activities
generalized
their
hours.
Students
carried
other
classrooms
challenging
other
activities.
the
investigating
in
and
the
during
should
effects
to
other
de
behaviors
Previous
re
of functional
to reduce
challeng
training
in new settings was also success
Future
research
& Carr,
1991).
the effects
investigate
other
environments
of this interven
such
as
in
the
and at home,
community
The present
to incorpo
study was designed
that uses positive
behav
rate use of the model
to enable
as a systematic
paradigm
intervention
for
of
an
AAC
implementation
ior support
behav
children
nent
consis-
the
should
to
students
their
and
iors.
reduce
These
ecdotal
to
self-injuriwere found
for the
maintained
issues.
ing behaviors
ful (Durand
espewant"
and
behaviors
and
to be
and
the
time
communication
started
oc
changes
the partici
as
peers
were
had
an
for taking a break
or changing
to his needs
and indicating
tivity. Referring
him the time left for each
activity seemed
enhance
class
decreased
their
behaviors
pants
aggressive
with their class peers and began
and
initiating
in social
more
behaviors.
Second,
engaging
to use
active
began
taking
spontaneously,
for
roles, and accepted
greater
responsibility
tasks.
classroom
completing
dally
switch
tasks,
behavioral
First,
other
search
available,
and
with Jo were
apparent
changes
to use the "Don't
when he learned
with
and
initiate
The
observed.
curred
creased
patterns
messages
were
from
participation
a VOCA
that
to the teacher
responding
in the classroom.
He also
academic
behavioral
re-
behaviors.
Dan
different
the participant's
behavior
Following
change
and reduction
in challenging
addi
behaviors,
tional
in other
students'
behaviors
changes
the
investigating
decrease
across
sages
left the
communication
for reductraining
behaviors
the finding
of
supports
ing escape
this study (Lalli,
&
Future
Kates,
1995).
Casey,
the impact
of the
research
should
address
students'
the staff of their
ability to inform
on
functional
desires
vention
challenging
demonstrating
most
first, and
important
this study
during
implemented
The
functional
the
lishing
the children
iors
in
were
the
nature
could
assessed
study.
AAC Support
clear
of the
that had
clear
strating
the student's
not
that
assessment
challenging
all
behav
the
functions
communicative
a
communicative
not be identified
one
behaviors,
challenging
for Reducing
estab
Thus,
for potential
participation
demon
seven
students
Of
and
in
assisted
behavior.
clear
compo
was the
and
Challenging
of
was
alternative
stu
an additional
Behaviors
103
dent
was
due
institution
to the
traumatic
who
again
by
as having
her
dents
to an
lenging
evaluated
nosed
moved
of the
inability
diag
psychiatrist
a psychotic
reaction
to a
in her past. For all other stu
event
the communicative
func
participating,
of their behaviors
was clearly established,
tion
in
of an intervention
development
team. Thus, challenging
plan by the classroom
behaviors
be associated
with
may not always
resulting
should
assess
a meaningful
municative
alternative
Once
was
student
ence
it was
means,
communicate
be
these
support
Horner
1991;
of
achieved
to
trying
it will be used.
could
It should
tion
individual
Additionally,
is easy to manipulate
(i.e., an
to activate
a switch accompanied
the previous
means
to
output),
easy method
with a voice
Day,
used
to an
convey
if that alternative
studies
to each
more frequently
and
of challenging
behav
that when
an effective
alter
is provided
a message,
be
findings
et al.,
noted
Previous
replaced.
Horner
(e.g.,
elimina
complete
behaviors
inappropriate
at any of the
&
1990).
that
and
cation
the new
However,
he would
others
of communi
and
art
had
circle
verted
communicating.
to challenging
search
should
sessments
methods
work
during
when
the class
successfully
activities.
time,
used
At those
times,
he
to
re
behaviors.
Further
re
the
of other
as
investigate
use
for
an understanding
establishing
of positive
solutions
to these frustrating
mo
ments of multiple
interactions
and turn taking
in larger groups.
This study poses
itive
behavior
the
enhancing
communication
mental
104
Education
along
who
for using
AAC
with
pos
for
of
functionality
manifested
retardation
possibilities
support
appropriate
with
by children
demonstrate
and Training
chai
in Developmental
sociated
and
to expand
factors
that are
with communicative
and
interactions,
positive
functions,
on
as
social
support.
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