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Posts Tagged ‘FBA’

Hi and welcome to Ask Missy Mondays where I take questions from readers. Today’s question comes from Judy who writes,

Hi Dr. Olive, my child’s school BCBA recently completed a Functional Behavior Assessment (FBA) for my child. The report seemed to be very detailed. However, I disagreed with the report because the BCBA did not include an assessment of my son’s scripting. The BCBA did not interview me as part of the FBA because it was a “school FBA”. I told the school that I wanted an Independent Educational Evaluation (IEE)/FBA at the school expense. Now they are telling me that they don’t have to give me an IEE because they think their FBA is good enough. Do I have any options?

Hi Judy, and thanks for writing. This is a great question and so very similar to some of the things I’ve seen happening in recent months. For example, one of my relatives requested an IEE for their child’s initial evaluation and the district filed due process against them! You can imagine how scary it is to be told that your school district is filing AGAINST  you!

I have a couple of points to address regarding your question. For my readers who are lost with all this terminology, you may read about an FBA here, learn about what to expect from an FBA here, and finally, learn the difference between an FBA and a functional analysis here.

Right to an IEE

First, if your child has an IEP, you have the right to request an IEE as long as the school completed their FBA within the past 12 months and you disagree with it. You don’t have to say why you disagree; just merely indicate you disagree.

The school does have a right to refuse the IEE by stating that their FBA is appropriate. At that point, you would have to file due process against them. I don’t recommend taking that step unless you have legal representation. Should you file due process against the school, you will need to prove why their FBA is insufficient.

I have heard of 3 different cases in Connecticut (I’m sure there are more) where the school refused to provide the IEE and so the family proceeded with a due process. In all 3 cases, the school district settled the case after the family spent precious time and resources gathering data, experts, and attorneys.

Parent Involvement in the FBA

My second point to your question is that the BCBA has a duty to involve you, the parent in the FBA. The reasons for this are twofold. First, the BACB Guidelines for Responsible Conduct require written parent permission to assess (see Guideline #3). Second, the BACB Guideline #4 requires client or guardian involvement during individual behavior change program planning.

“The behavior analyst (a) designs programs that are based on behavior analytic principles, including assessments of effects of other intervention methods, (b) involves the client or the client-surrogate in the planning of such programs, (c) obtains the consent of the client, and (d) respects the right of the client to terminate services at any time.”

If the parent disagrees with the FBA, how could the parent possibly be involved in the planning of the program? The BCBA should minimally involve the parent/guardian throughout the FBA and the BIP.

Research on Family Involvement

My third point to your question is to highlight the research on the importance of family involvement during the assessment and intervention process. For starters, including families in the process will serve to help educate parents on the assessment and intervention process. This education may then go on to reduce parenting stress (c.f., Bristol, et al., 1993; Gallagher, 1991; and Koegel et al., 1996). Second, professionals should be conducting assessments and development interventions utilizing a multicultural lens (c.f., Harris, 1996; Heller et al., 1994). Without parent involvement, cultural competence cannot be achieved.

In summary, if your child’s BCBA, behaviorist, behavior specialist, or similar completes an FBA on your child and you disagree with it, be sure to ask your team for an independent educational evaluation (IEE).

References

Bristol, M.M., J.J.Gallagher, and K.D.Holt 1993 Maternal depressive symptoms in autism: Response to psycho-educational intervention. Rehabilitation Psychology 38:3–9.

Gallagher, J.J. 1991 The family as a focus for intervention. In Handbook of Early Childhood Interventions, S.Meisels and J.Shonkoff, eds. Cambridge MA: Cambridge University Press.

Harris, S.L. 1983 Families of the Developmentally Disabled: A Guide to Behavioral Intervention. Elmsford, NY: Pergamon Press.

Heller, T., R.Markwardt, L.Rowitz, and B.Farber 1994 Adaptation of Hispanic families to a member with mental retardation. American Journal on Mental Retardation 99:289–300.

Koegel, R.L., A.Bimbela, and L.Schreibman 1996 Collateral effects of parent training on family interactions. Journal of Autism and Developmental Disorders 26:347–359.

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Hi and welcome to Ask Missy Mondays where I respond to a question from readers regarding a behavioral problem. Today’s question comes from a speech and language pathologist who works in a center for individuals with autism. The question is:

“The question I have is regarding a 3-year-old boy who has been diagnosed with autism. He started therapy with us and progressed very well. He is now able to follow commands. He imitates well and he is starting to vocalize single word utterances. He was able to focus for approximately 20 min with a reward and he really cooperated well. However, in the last 3 weeks, all of this positive behavior has changed. He now throws tantrums throughout the session. He bites if his needs are not met  and this is particularly if he does not get what he wants. We have tried rewards with the child but he cries and throws a tantrum for the reward if we only give him a part of it. In the session, we ignore the tantrums. It is unclear if the parents are ignoring the behavior at home or if they are giving in to the behaviors.”

Thank you so much for contacting me. Any time a child’s behavior changes suddenly, the adults should stop and ask “what has changed in his life”?

Any Changes in Home/School?

  • is he in a new classroom?
  • has his home environment changed?
  • has his feeding routine changed?
  • has a new therapy program been added/changed?

Any Medical Conditions or Medical Changes?

The other question to ask is about his medical condition. Medical conditions can impact behavior.

  • is the child constipated?
  • was he recently vaccinated?
  • was he recently sick?
  • is he teething?
  • is he tugging at his ear or are there signs of a sinus or infection?

Functional Behavioral Assessment

Once you have run through those questions, the next step is to complete an FBA. You have to document what is happening before and after the behavior to find out what might be causing the behavior or what might be maintaining the behavior. Typically, children use their tantrums to try to get things they like:

  • get attention
  • get favorite toy
  • get favorite activity
  • get favorite sensory

Sometimes, children use tantrums to avoid things they do not like:

  • avoid non-preferred person (e.g., therapist who makes me work)
  • avoid a non-preferred toy
  • avoid a non-preferred activity (e.g., work)
  • avoid sensory

Additionally, the child may engage in tantrums for any of the reasons combined (e.g., avoid work and then obtain favorite toy while on break).

Behavior Intervention Plan

Following a good assessment, then the team will need to develop a solid behavior intervention plan.

  • Staff and parents will learn how to prevent the behaviors
  • Staff and parents will learn how to teach replacement behaviors
  • Staff and parents will learn what to do after behaviors if they happen.
  • Staff and parents will learn how to reinforce the new replacement behaviors to that they continue to occur.

Please keep me posted on the outcome!

Thanks again for writing. Readers, if you have a behavioral question, email me at askmissy at applied behavioral strategies dot com.

I would appreciate any advice you can provide us in trying to help this child. As you might be aware services and facilities for children with autism are limited so any information you give us will be very useful.

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Hi and welcome to Ask Missy Mondays where I respond to a question from readers regarding a behavioral problem. Recently, I was asked, “Where have you and Rebecca been? We have missed the regular blog postings.”

Busy IEP Season

In all honesty, neither Rebecca or I followed our own advice regarding Individualized Education Program (IEP) season. We both had a number of annual reports to submit in preparation for meetings.Those reports need to show how much progress our clients have made over the past year and we need to document our clients’ present level of performance (PLOPs) for the schools’ IEPs.

Independent FBAs

However, in addition to those items, we have both been asked to complete Independent Educational Evaluations (IEEs) of behavior. It is not uncommon for a school to complete a Functional Behavioral Assessment (FBA) as required under the Individuals with Disabilities Education Improvement Act (IDEIA). But the IDEIA also affords the family a right to an independent FBA should they disagree with the findings from the school FBA. Independent FBAs also take substantial time.

Conferences

Both of us have been conferencing. First we had the Association of Behavior Analysts Annual Convention in Seattle. This conference is a must for behavior analysts or anyone interested in the field of behavior analysis. Days are filled with research, practical application, and behavior analysis across contexts while nights are filled with socialization and mingling with other behavior analysts (about 5,000 of your closest friends). While there, we conducted a day-long workshop on Special Education Law and Ethical responsibilities for behavior analysts. We also presented ethical responsibilities for completing FBAs, Behavior Intervention Plans (BIP), and the proposed law on restraint and seclusion.

Region 17 invited me to speak at their Autism Conference in Lubbock, Texas. If you live in the area, this is a conference that should not be missed. Anna Phillips runs an amazing conference with great speakers and a wide variety of topics. The exhibitors are also great and participants can purchase books, teaching materials, and even fun jewelry. I presented on behavioral feeding techniques, data collection, and using the iPad to teach communication, language, and academic skills.

Webinars

We offer continuing education for Board Certified Behavior Analysts and we try to offer a topic each month. We have recently completed webinars on Special Education Law and Using the iPad to Teach. While the webinars are designed for behavior analysts, anyone is welcome to attend. If you are interested in our upcoming webinars, check out our website for additional information or for registration instructions.

We Are Hiring!

Finally, Applied Behavioral Strategies continues to get referrals for ABA therapy, behavioral feeding therapy, and assessments. Because of all of these referrals, we are in need of a Board Certified Behavior Analyst (or two) as well as good front line therapists. So, if you like what we do, please consider applying for a position. If you live in Connecticut, contact me directly. If you live in or near Austin, contact Rebecca.

So, we apologize for our absence in recent weeks but we appreciate your on-going support.

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Hi and welcome to What Works Wednesdays where we share a success story from one of our clinical cases. All names have been changed to preserve the privacy of the child and family. Our intent is to show readers how successful ABA can be.

Readers really gravitated to our story on Monday about adults with disabilities so we thought we would share a success story about one of the adults we have served. Alwan’s adult service provider reached out to us because they needed help with his Self Injurious Behavior (SIB). Alwan hit his head about 2,000 times per month. The SIB was so severe that Alwan was required to wear a helmet all day. Alwan was blind in one eye from the SIB and he was developing cataracts in the other eye. Alwan was 28 years old and carried several diagnoses including profound mental retardation and autism.

Record Review

Because we “inherited” Alwan, we first completed an extensive record review. From the record review we learned that Alwan was heavily medicated in an attempt to decrease the SIB. Alwan had no formal communication system. Alwan had serious feeding issues and was on a strict puree diet. Additionally, he had a protocol for drinking liquids to prevent aspiration. Finally, Alwan had 1:1 staffing all day and 2:1 staffing when out in the community. Additionally, he was “pre-sedated” before all appointments and the staffing ratio on appointments was 4:1.

The record review also referenced a set amount of top spinning time. From the review we learned that Alwan enjoyed spinning tops, lids, etc. We did not, however, understand why this time was limited to only 30 minutes per day.

Functional Behavioral Assessment

The next step was to complete a functional behavioral assessment. We have defined, described, and given examples of these before. To get started, we created an ABC chart for the staff to complete when they observed these behaviors.

We also completed direct observations of Alwan. The observations revealed that Alwan was physically tugged, pulled, and directed all day long. Staff literally dragged him from place to place. Moreover, he had no choice about what to eat, what to drink, or even how to spend his time. Because he lacked communication, staff determined everything for him. The only thing Alwan could control was dropping to the floor and hitting himself in the head.

The observations also provided clarity about the issue around top spinning. When Alwan spent time spinning tops, he became very “worked up” and excitable. All of those behaviors led to an immediate increase of SIB. Essentially, he rocked, flicked the tops, watched them spin, laughed, and then proceeded to hit himself. However, if top spinning did not occur, head hitting was kept to a minimum.

We conducted interviews with staff to find out additional information about Alwan and his behavior. Staff revealed that Alwan really enjoyed walking to the park and riding in the van. Alwan also enjoyed taking a bath.

Many times, SIB is associated with pain, so we asked a few questions to help determine if underlying pain existed. We learned that Alwan had gastrointestinal (GI) issues that needed medical attention so we referred Alwan for a GI workup. Honestly, one bowel movement every 5 days is enough to make us hit our heads a few times.

Finally, we noticed that whenever Alwan was denied something that he wanted, he engaged in head hitting as if to say he was mad about being told no.

Intervention Priority: Communication

Our first concern for Alwan related to his need for a method of communication. We encouraged the provider to hire a speech and language pathologist to help design an appropriate communication system for him. Seriously, who graduates from a program at age 21 without a form of communication? We feel strongly that his IEP team neglected their duty to teach him important skills such as effective communication.

Intervention Priority: Leisure Skills and Reinforcement

We recognized early on that top spinning was a problem. First, it is not an appropriate leisure skill. Second, top spinning was directly correlated with head hitting. Thus, we wanted Alwan to learn new leisure skills. We also wanted Alwan to have more time doing the things he enjoys such as taking baths, going for van rides, and taking walks in the park. It is important for Alwan to have a meaningful day filled with things that he enjoys (and is capable) of doing.

Intervention Priority: Response Interruption and Redirection (RIRD)

Finally

Intervention Priority: Staff Training

We scheduled time for the staff to learn about why challenging behavior occurs. We also reviewed the current BIP and discussed our suggestions regarding changes to the BIP. We taught them how to increase the amount of time that Alwan spent doing things that we liked. We taught them how to interact with him in a way that decreased the amount of time their hands were tugging on his body and increased the amount of time they had positive physical interactions with him. We also taught staff how to implement RIRD.

Outcome

The team is continuing to follow up on Alwan’s GI care. They are making sure that he has regular bowel movements. They are increasing his opportunity for choice in what he eats and what he drinks. They are increasing access to preferred activities such as van rides and trips to the park.

The speech and language pathologist continues to work with staff on developing and implementing a formal mode of communication for Alwan. He is beginning to point to indicate what he wants and needs.

Staff are learning to attend to positive behaviors and to interrupt negative behaviors. They are also learning to interact with and enjoy Alwan.

Most importantly, Alwan has reduced his head hitting to only a few episodes each month! Isn’t it amazing how effective an assessment and function-based approach can be?

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Take a look at our picture below. (Thanks go out to Bil Keane for this wonderful cartoon (c) 1976.) See if you can guess why PJ is tantrumming. When there is a reason for a behavior, behavior analysts called it a function or a purpose. This is the first time we have tried a poll so please participate! We will post the answer tomorrow! Thanks for playing.

Let's BEE Friends

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Here at Applied Behavioral Strategies, our mission is to improve the quality of life through effective intervention. One way we hope to do that is by reviewing research articles for our readers. The title of today’s article is State Special Education Laws for Functional Behavioral Assessment and Behavior Intervention Plans. Perry Zirkel authored the article and Behavioral Disorders published it in August, 2011 (Volume 36, number 4).

Purpose

The author set out to analyze state laws regarding Functional Behavioral Assessments (FBA) and Behavior Intervention Plans (BIP). For background information related to federal requirements for FBAs and BIPs, read Dr. Zirkel’s introduction. He provides information regarding the law, regulations, and federal interpretations of the law.

Method

The author searched  for state laws regarding FBAs and BIPs. Keep in mind, states may only add to federal legislation, not take away from requirements. Then he tabulated the information adding a “when”, “who”, “what”, and “how” column. Specifically, the “when” column identified if a state identified when the FBA and BIP were required. The “who” column indicated when a state identified the parties responsible for completing the FBA and developing the BIP. The “what” column indicated when a state defined the FBA and BIP. Finally, the “how” column identified when a state included information about how to complete an FBA and BIP.

Results

Key finding #1. Thirty-one of the states have requirements regarding FBAs and BIPs.

Key finding #2. Twelve of the 31 states fail to identify both the “who” and the “when”.

Key finding #3. Zero of the 31 states require both an FBA and a BIP when a child’s behavior interferes with the child’s learning or that of others. May we note that this seems absurd to us? How can a BIP be developed without an FBA? And how could an FBA not result in a BIP? We are terribly saddened by this finding.

Key finding #4. Only 2 states provided information about how to complete both an FBA and BIP. Meanwhile 12 states provided some information about how to complete a BIP.

Key finding #5. Seventeen states define FBAs and BIPs with only 14 of the 17 mentioning “function” with regards to FBA.

Conclusions

As parents, teachers, behavior analysts, and/or advocates for children with behavioral challenges, we have a duty to make changes at the state level to ensure that students are protected with policies that will result in appropriate assessment and intervention. Protective policies regarding FBAs and BIPs will most likely prevent the use of scream rooms and other inappropriate behavior reduction techniques.

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We have been to a number of IEP meetings where the results of a Functional Behavioral Assessment (FBA) were presented. You won’t believe some of the things we have heard! Check out this list:

  1. Your child doesn’t need an FBA. FBAs are for children who have severe emotional problems.
  2. Here is our FBA form, let’s fill it out so we can write the Behavior Intervention Plan (BIP).
  3. You cannot ask for an independent FBA. An FBA is not an assessment.
  4. We finished your child’s FBA. The function of your child’s behavior is anxiety.
  5. We finished your child’s FBA. The function of your child’s behavior is control.
  6. We tried to do an FBA but your child does not have any behaviors.
  7. I don’t know how to graph your child’s functional analysis results. They didn’t teach me how to graph in school.
  8. We don’t need a behavior analyst to do the FBA. Our special education teacher took a class on behavior. She can do it.
  9. Why did your report say the child escaped? Our staff keep children within arm’s length at  all times.

And the number 1 craziest thing we have heard about FBAs:

10. We cannot do an FBA as part of the initial evaluation. We have to see how he behaves in special education first.

Please share! What crazy things have you been told about an FBA? Behavior analysts, what have you heard?

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