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Precision Measurement and Decision Making to Reduce Challenging Behavior

Sal Ruiz
Sep 4, 2018 5:09:09 PM

Challenging behavior can hinder children diagnosed with Autism Spectrum Disorder (ASD) academically and socially. Depending on frequency, severity, and type of response, serious health risks may occur. Challenging behavior requires immediate treatment to reduce the response and teach replacement skills. In applied behavior analysis, treatment involves operationally defining behavior, an assessment of some type, data collection, treatment plan, and data monitoring. However, extraneous and confounding variables in the applied setting (e.g., schools, homes, social settings) may create difficulties for a behavior analyst in making decisions regarding treatment.

Precision Teaching (PT) provides powerful measurement tools that can assist those working with clients diagnosed with ASD. The four components of PT (See Figure 1) promote best practices to help improve the quality of life for those requiring services.

prcta cycle

Figure 1: The PRCTA Cycle which guides Precision Teaching practice.

For example, John, a 9-year-old boy diagnosed with ASD, frequently picked his skin and created visible wounds that frequently bled. Using the pillars of Precision Teaching, the frequency of the behavior decreased significantly and by the end of the school year his behavior had completely stopped. Each step of the process provided a high level of precision measurement. Pinpointing provides an accurate description of a discrete movement, recording shows a visual depiction of behavior, change allows for analysis of data, and try again requires analysts to continue looking for interventions that lead to adequate change.

1. Pinpoint

The first component of PT, pinpointing, assists in precisely defining both the target behavior for change and replacement behavior. Pinpoints differ from traditional operational definitions for data collection, because these definitions will often group topographically similar responses under a larger term (e.g. Rodriguez, Thompson, Schlichenmyer, & Stocco, 2012). However, the grouping does not ensure that each behavior is a member of the same functional response class, leaving the possibility of variability in the data.

John’s Self-Injurious Behavior (SIB), for instance, had previously been defined with multiple behaviors:

Self-Injurious Behavior - pinching, picking, hitting, smacking, kicking, banging a body part off of a hard surface with force.”

However, a pinpoint differs from operational definitions by using one discrete behavior and connected context (Kubina & Yurich, 2012). A pinpoint would define the behavior as

Picks skin with fingers on face.”

The key difference for the pinpoint boils down to offering one clearly defined and easy to count behavior facilitates highly accurate counts and improved data collection. Further, one specific behavior serves as the basic unit of analysis. Pinpoints do not assume topographical response classes have functional equivalence.

2. Record

The next component of PT provides analysts with their visual displays of data (Record). Once data collection begins, behavior analysts should chart their data daily to make decisions. PT uses a standardized visual graphic called the Standard Celeration Chart (SCC). The SCC is a ratio chart which provides a host of benefits, and one such virtue is the quantification of change. When charting challenging behavior, quantification on the SCC assists in decision making by placing numerical values on the growth or decay of the target response. Knowing that a challenging behavior is decaying by 25% per week, the BCBA may determine a new intervention or component to the treatment is needed.

Figure 2 depicts a behavior that had varying rates of decay with multiple interventions to bring the behavior to zero rates of responding. Consider the case of John from above. Daily recording of his pinpoint provides frequent monitoring to make decisions regarding treatment. Using the SCC and daily charting encourages frequent decision making. When a target behavior requires a reduction program, the SCC provides a fine-grained analysis.

phillip bx reduction chartFigure 2: SCC depicting frequency of pinches through a four month time period. 

3. Change

Once data are placed on the SCC, visual analysts can begin to determine the effects of the intervention. If adequate progress has not occured, Behavior Change Agents alter their approach. Such changes may include an additional component to the intervention, a new intervention, or a removal of a component of an intervention. After and during, progress is assessed to determine whether to continue, change, or complete the intervention.

In the case of John, frequent analysis of celeration, level, and bounce led to decreases in picks skin response. Due to high occurrence of the picks skin behavior, a response block intervention reduced behavior, but did not eliminate it. John then received modification of instruction that included frequency building of skills and increased pace of delivery of instruction. Pairing the faster instruction with response blocking decreased the response.

The key to applying Precision Teaching is the ability to frequently display and analyze data.

4. Try Again

When the intervention has not produced adequate changes in behavior, then Behavioral Change Agents continue to try until a solution is found. By never giving up on a learner or their progress Behavior Change Agents can effectively implement PT principles to reduce behavior. In the case of John, systematically evaluating procedures through Precision Teaching assisted in the prevention of injury. Children that engage in challenging behavior need socially acceptable replacement responses to improve their lives. Pairing the principles of behavior analysis with a powerful measurement tool and the components of Precision Teaching can help those that require services.

References

Kubina, R. M., & Yurich, K. K. L. (2012). The Precision Teaching Book. Lemont, PA: Greatness Achieved.

Rodriguez, N. M., Thompson, R. H., Schlichenmeyer, K., & Stocco, C. S. (2012). Functional analysis and treatment of arranging and ordering by individuals with an autism spectrum disorder. Journal of Applied Behavior Analysis, 45(1), 1–22. http://doi.org/10.1901/jaba.2012.45-1

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