Positive Behavior Support and Early Intervention

Temperament predicts challenging behavior in children with autism spectrum disorder at age 5

Parent education programs have become an effective mode of treatment delivery for teaching families effective behavioral strategies to manage challenging behavior in young children with autism. Functional assessment and functional communication training (FCT) are empirically validated procedures that have recently been introduced into parent education programming to help resolve challenging behaviors. The success of these procedures, however, is contingent on family members' ability to integrate them into the specific contexts in which challenging behaviors occur. Consequently, the application of these procedures in home settings necessitates consideration of the family context in the assessment and treatment planning process. A study is presented that investigated the use of information on family context (i.e., caregiving demands, family support, patterns of social interaction) to direct the assessment and intervention planning process. More specifically, information on family context was used to individualize behavioral support plans designed to support family use of functional communication training within important family routines. Through parent-investigator collaboration we individualized the manner in which functional communication training procedures were taught and implemented so they were contextually relevant. Utilizing a multiple baseline design, the challenging behaviors and functional communication of three children with autism were monitored across baseline, intervention (i.e., FCT, and contextulized FCT), and follow-up phases. Multiple routines for each participant were selected and monitored across all phases to evaluate changes in the dependent measures within training and generalization routines. A self-report questionnaire was administered intermittently to parents to determine if consideration of family context improved the "goodness of fit" of the functional communication training treatment packages across FCT and contextualized FCT intervention phases. Results from the study indicate that consideration of family context in the assessment and intervention planning process does not jeopardize and may contribute to the stability and durability of reductions in challenging behavior achieved with functional assessment and functional communication training procedures.

© 2019 Elsevier Ltd Background: Challenging behaviors during early childhood have a significant impact on cognitive and social development. The present study aimed to identify the developmental predictors of these behaviors in preschool aged children with Autism Spectrum Disorder (ASD) at 2-year follow-up. We examined temperament, which has been identified as key to emotion regulation in typical development, as well as developmental level and ASD symptom severity, as potential predictors of parent-reported challenging behavior. Method: Forty-three parents of preschool aged children with ASD from a previous study were invited to participate. Data from 26 children with ASD aged 4–6 years (M = 5, SD = .60) were available for follow-up analyses. Developmental level, ASD symptom severity, and temperamental difficulty at baseline were considered as potential predictors of frequency and severity of challenging behavior at follow-up. Results: Baseline negative affectivity was uniquely predictive of frequency of challenging behavior at follow-up. Although no individual variable was identified as a unique predictor of variance, the combined effects of temperament were predictive of the severity of challenging behavior at follow-up, contributing to 46 % of variance in scores. Conclusions: These findings highlight the potential impact of emotion-regulation related aspects of temperament on later emerging challenging behavior in young children with ASD, suggesting opportunities for early intervention. Results also identified a role for developmental level in the severity of challenging behavior, but suggest that the effect may be metered by temperament.

Intervention studies to reduce challenging behavior in young children below the age of 6 were reviewed for participant characteristics, including gender, race/ethnicity, disability, socioeconomic status, and language to evaluate the frequency of reporting and diversity of participant characteristics in this area of research. Interventions conducted in school, preschool, and home-based settings were included; 53 articles were reviewed. In these articles utilizing single case research or group designs ( n = 2,262 participants), most articles reported gender and disability. Slightly fewer than half of the studies reported participants’ race/ethnicity. Socioeconomic status and language were infrequently reported. Analyses of participant characteristics in studies that reported children’s gender and race/ethnicity found that boys and Black and Latino children were overrepresented. Implications are discussed, including the field’s use of research standards regarding the reporting of participant characteristics, suggestions for inclusive recruitment and retention strategies, and the importance of identifying culturally responsive interventions for challenging behavior.

In this study, the authors examined the parenting practices, developmental expectations, and stress levels of 136 fathers and the challenging and prosocial behaviors of their 1- to 5-year-old children. In addition, the authors systematically addressed fathers' qualitative concerns about their parenting. The authors divided the participants into 4 groups and controlled for family socioeconomic status (SES) and the focus child's gender. Results showed a significantly higher use of corporal and verbal punishment and parenting stress among lower income fathers. Secondary analyses demonstrated a significant effect of paternal disciplinary practices that emphasized the frequent use of corporal and verbal punishment on child behavior problems, regardless of SES level. On a positive note, fathers from both lower and higher SES groups had reasonable developmental expectations for their boys and girls, and they reported similar frequencies of their children's prosocial behavior. The authors discuss the need for early parent education programs that include fathers and that teach specific strategies to address child behavior problems.

Challenging behavior in young children is common. It can be difficult for parents or early childhood professionals to know what behaviors fall within the typical range of behavior. This chapter outlines the prevalence of common behavioral concerns among young children (sleep problems, feeding issues, colic/excessive crying, toileting issues, fears/worries/anxiety, sexual behaviors, aggression, and social skills) and outlines guidelines for how to address these concerns. Strategies to ensure cultural competence in working with a diverse range of families are also outlined.

This article describes the quantitative findings from an evaluation of program-wide positive behavioral interventions and supports (PBIS) in three rural preschool programs. Each rural preschool program included children 3 through 5 years of age with and without disabilities. Following 3 years of on-site training, technical assistance, and coaching support in universal tier PBIS, participating preschool programs increased their use of strategies and supports to prevent young children's challenging behavior. Specific improvements in universal PBIS practices are presented across each year of the initiative. The successes and challenges involved in implementing program-wide PBIS in rural preschools are discussed.

Maternal depression and children's challenging behavior have been linked to school readiness, yet few studies have examined how they interact to shape Hispanic children's preacademic competence. This study investigated whether children's challenging behavior mediates the relationship between maternal depression and academic competence among low-income immigrant Hispanic families. Participants included 167 low-income immigrant Hispanic mothers with preschool-aged children enrolled in community-based childcare programs. Despite adverse circumstances, most Hispanic mothers reported low levels of depression, while children exhibited moderate levels of challenging behavior and preacademic competence. Mediational analyses indicated that maternal depression was indirectly associated with children's preacademic competence through its influence on challenging behavior. The findings underscore the importance of supporting Hispanic mothers in managing challenging behavior and fostering prosocial development to enhance children's preacademic competence. This study informs family and consumer sciences professionals serving Hispanic families with young children, emphasizing the need for culturally responsive, integrated practices that support mental health, parenting, and preacademic competence to promote school readiness.

In the field of intellectual and developmental disabilities, for example, caregivers provide services to people with serious and persistent behavioral challenges, particularly physical aggression and property destruction. Typical treatments involve psychopharmacological, behavioral, and cognitive-behavioral strategies. The mindfulness-based positive behavior support (MBPBS) course has two major components: positive behavior support and mindfulness practice. Caregivers need to have a good grounding in positive behavior support because it gives them the basis for assisting people to change their behavior. They also need to have a disciplined mindfulness meditation practice that will enable them to provide the services mindfully without being psychologically stressed, emotionally exhausted, and burned out. The MBPBS program is an emerging research-informed mindfulness-based program for caregivers of people with a diverse range of behavioral challenges. MBPBS was developed to address the need for a holistic intervention that targets the caregiver-client dyad, and the interconnectedness and transactional nature of their behavior.

Children with autism spectrum disorder (ASD) often demonstrate deficits in executive function, which can lead to poor academic achievement and an increased risk of challenging behavior (Oswold et al., 2016). This is troublesome, as children with ASD are already at a higher risk for academic difficulties, behavior dysregulation, and behavioral excesses (St. John et al., 2018). The most prevalent function of challenging behavior for children with ASD is escape from instructional demands (Melanson & Fahmie, 2023). While the efficacy of focused interventions to decrease challenging behavior in children with ASD has been identified, limited research has included academic or preacademic skills as an outcome measure (Steinbrenner et al., 2020). Therefore, further research is needed to target instructional modifications to abate the aversiveness of task demands and include academics as a measurement outcome. The purpose of this study was to evaluate the impact of an antecedent-based intervention, video-enhanced activity schedules, on child challenging behavior, on-task behavior, and independent activity completion. The study included four preschool-aged children with ASD and four registered behavior technicians in one clinic. This study utilized a concurrent multiple baseline design across participants with random assignment to evaluate the effects of the video-enhanced activity schedule on child challenging behavior, on-task behavior, and independence. Results demonstrated that the functional relation between implementation of the video-enhanced activity schedule and decreases in challenging behavior was not conclusive. However, there was a functional relation between the implementation of the video-enhanced activity schedules and an increase in on-task behavior and independence for child participants. Additionally, social validity measures indicated that implementers and children found the intervention to be socially valid. Implications for future research and practice are discussed.

Staff beliefs about the challenging behaviors of children and adults with mental retardation

Training programs on the topic of challenging behaviors have often been offered to teaching staff and family carers of children with intellectual disabilities (ID). These efforts have been found to be effective in bringing about positive changes for both children with ID and those who support them. Generally, such training has been offered to either staff or family carers but not at the same time. The authors conducted a study to evaluate the efficacy of a brief training program delivered at the same time to teaching staff and family carers (who were involved with the same child). The study also examined differences in outcomes between the two groups, which were drawn from local schools where some children exhibited challenging behaviors. Both teaching staff and family carers completed the Checklist of Challenging Behaviour, the Challenging Behaviour Attributions Scale, and the Emotional Reactions to Challenging Behaviour Scale prior to, and following, the training workshops. The workshops were divided into two segments. The content was the same, but in the first segment, one was held for teaching staff and one for parent carers. In the second segment, both groups met together. After the first segment, all participants completed a related homework task before joining each other for the second segment. Training used a functional model of challenging behavior and facilitated the production of individualized support plans for the target children. Significant positive changes were found regarding ratings of challenging behavior, participants' causal attributions, and emotional reactions following the training. Some differences were found regarding outcomes for teaching staff vs. family carers. The study showed that teaching staff and family carers can benefit from receiving combined training to support challenging behavior in children with ID.

Children with autism tend to engage in challenging behavior more than other children, which impacts their ability to engage appropriately with instructional tasks. Existing literature has established that visual activity schedules are effective for maximizing on-task behaviors and reducing challenging behavior in individuals with autism. However, in some cases challenging behavior may not be effectively reduced, especially when the visual activity schedule includes a less preferred task. This study aimed to address this need by (a) examining the effects of a treatment package consisting of a visual activity schedule and instructional choice on escape-maintained challenging behavior of children with autism during less preferred tasks and (b) comparing the effects of the treatment package with a visual activity schedule only treatment. Results suggest the treatment package effectively reduced challenging behavior during less preferred tasks and had more consistent effects than the visual schedule only treatment on the reduction of challenging behavior.

Positive Behavior Support has been shown to be effective in minimizing challenging behavior. Therefore training staff in Positive Behaviour Support would appear to be helpful in improving support to people with challenging behavior. The purpose of this review was to evaluate the research on the outcomes of Positive Behavior Support training. There are no other published reviews of Positive Behavior Support training outcomes. Searches were carried out using key words to identify studies which reported on Positive Behavior Support training. Following this, studies were evaluated against criteria for inclusion. 14 studies were identified by the review. Six studies focused on outcomes for staff. Four focused on outcomes for service users. Four studies reported outcomes for both staff and service users. Staff outcomes included changes in skills, confidence, knowledge, attributions and emotional responses. Service user outcomes demonstrated reduction in levels of challenging behaviour, but no evidence of change in quality of life was evident in the one study that evaluated this. Research demonstrates that Positive Behavior Support training has had a positive impact on knowledge, emotional responding, and attributions of staff. In addition, there is evidence of reductions in levels of challenging behaviour from service users. However, no evidence was found for Positive Behavior Support training having a positive impact on quality of life for service users.

Positive Behavioural Support (PBS) is an approach for supporting people with challenging behaviour that emphasises improving their quality of life. Using alternatives to punishment and other restrictive practices, PBS aims to remove the barriers to participation that result from challenging behaviour. The foundations for the PBS approach can be found in nonlinear Applied Behaviour Analysis (ABA), with an emphasis on teaching alternative behaviour. More recently, this approach has included the use of counter-intuitive, nonrestrictive strategies for rapid, safe situational management as an alternative to the physical management of challenging behaviour. PBS is used by many practitioners in countries around the world.