Center for Evidence-Based Practice: Young Children with Challenging Behavior

Building a Behavior Support Team | Person-Centered Planning | Functional Behavioral Assessment | Hypothesis Development
Behavior Support Plan Development | Monitoring Outcomes | Synthesis of the Research | Case Studies

  

  Monitoring Outcomes
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Once the child’s behavior support plan is developed, the behavior support team’s role is both to implement the plan itself and to monitor progress toward outcomes valued by the child’s family. The keys to successful outcomes are frequent data collection and consistency—relative not only to both when, where, and who implements the plan but also to how the plan is implemented (i.e., whether or not the same intervention steps are followed). Data collection (e.g., direct measurement and indirect measurement) should occur to document whether the plan is implemented with consistency and is effective in achieving the identified goals, as well as whether or not the replacement skills are durable over time (maintenance) and/or across settings/contexts (generalization). Data should be both easy to collect (e.g., rating scales, check sheets) and should be periodically reviewed by the behavior support team to ensure communication, make any adjustments as needed, and review progress relative to the long-term vision of the child and his/her family.

Data Collection

The most traditional form of ongoing assessment or data collection is a quantitative method that assesses progress through direct measurement of the child’s behavioral performance. Using direct measurement, behaviors are defined and measured during intervention, during "skill probe" periods (attempts by the child to perform the skill without instruction), and/or at other times when the behavior may be expected to occur.

Defining the Behavior

Direct measurement of a child’s skill development requires that the team first identify the skills or behaviors that will be measured and then select an appropriate unit of measure. A primary rule for describing what will be measured is to adequately define the behavior so there is no mistake about when it occurs and when it does not. The rule of thumb is that a behavior should be defined so that it is clearly understood by persons outside of the child’s support team.

Measuring the Behavior

Once the behavior has been identified and adequately defined, the team’s next step is to observe the child during predetermined activities and routines in order to note the occurrence of challenging behavior as well as the replacement skills that are taught. Behavioral data may be recorded in several ways. However, in each, the basic process requires that the observer make a written note or place a mark on a data collection sheet, then transfer the mark to a corresponding graph or chart. Following this rationale, four general suggestions apply when selecting which form of measurement to use when collecting data: 1) the particular type of measurement must be easy to use; 2) the measurement must provide meaningful information; 3) the process of measurement should not interrupt or detract from the instructional flow; and finally; 4) measurement should fit within the child’s natural environment—it should not create artificial conditions that are inconsistent with the child’s natural activities or routines. Following these guidelines, the team is able to use either direct measurement or indirect measurement procedures to measure a child’s behavior. Although both will be described individually, some teams may elect to use direct and indirect measurement procedures together in order to provide an even more comprehensive picture of the child’s performance and the support plan’s outcomes.

Maintenance

Maintenance refers to the continuation of conditions associated with the performance of a specific behavior (Cooper, Heron, & Heward, 1987). In simpler terms, maintenance refers to the continued use of a behavior over time, especially once an intervention has been conducted or discontinued because the child has demonstrated an ability to successfully perform the behavior. Among the more popular strategies used to promote maintenance are changing the frequency and/or ratio by which reinforcement is provided, systematically removing or fading prompts over time, and teaching self-management skills.

Generalization

Generalization refers to the spread of the effects of reinforcement (or other operations, such as extinction or punishment) during one stimulus to other stimuli differing from the original along one or more dimensions (Cooper, Heron, & Heward, 1987). In less technical terms, generalization refers to the child’s ability to transfer the use of replacement skills to new contexts, such as a new setting/location, a new person, or a new activity or routine. An example of generalization would be a child who originally learns to request help from his preschool teacher in the classroom and later requests help from the same teacher outside on the playground.


Direct Measurement

Direct measurement provides the most accurate representation of a child’s behavior or skill acquisition and is the preferable approach to use to measure change. However, the use of direct measurement by busy families and providers is not often possible. Indirect measurement may offer a more user-friendly approach.

 

Event Recording

The number of times a skill is observed. This is measured by counting the number of times a behavior occurs. It is important that a specific behavior has a clear beginning and ending point in order to ensure accurate measurement. An example of even recording might be recording the number of times a child leaves the table in a 20-minute snack time. This method is also referred to as frequency recording.

Percentage

Another relatively easy way to collect data is to determine the percentage in which a behavior occurs. In order to do this, simply identify the number of times a behavior occurs, divide it by the total number of chances the child had to perform the behavior, and multiply by 100. For example, if a child is given 10 chances to stack three blocks and successfully stacks 3 blocks seven times, the percentage would be 70%.

Rate

Rate entails measuring the number of times a behavior occurs relative to a period of time. This is calculated by measuring the number of occurrences divided by a number of time units. For example, a teacher using rate measurement might calculate the number of times per minute a boy bites his hand. Although a useful tool, this can be difficult to track when measuring high frequency behaviors.

Interval Recording

Interval recording is similar to event recording and measuring rate but differs in that behavior is recorded within small blocks of time (e.g., 10-seconds) called intervals that together represent a longer period of time (e.g., 10-minutes). Observers use a data collection form that contains a series of intervals. Behaviors can be scored as occurrences if they occur at least once at any time during the interval (i.e., partial interval recording) or if they occur for the entire duration of an observation interval (i.e., whole interval recording). In general, partial interval recording is most often used to measure behaviors that are likely to be short in duration (e.g., hitting, biting), whereas whole interval recording is most often used to measure behaviors that are expected to occur continuously for a period of time (e.g., sitting in seat).

Unlike event recording, each discrete behavior being observed is measured on relative to distinct intervals of time. At the end of the interval period, the observer makes a check mark in the corresponding area to mark the occurrence of a behavior. The observation continues to the end of the next interval and another mark is made if the behavior recurs. Scores for interval recording are calculated as a percentage—the number of occurrences are divided by the number of opportunities, and then multiplied by 100.

 

Duration

The amount of time behavior occurs in an observation period (e.g., the amount of time the child sits at the table to eat). Measured by recording the amount of time a behavior occurs. Unlike the previous measures, duration is a measure that is useful for measuring how long a continuous-ongoing behavior lasts. Like event recording, duration is a direct measure of the actual behavior, not an estimate like interval recording.

The most precise way to observe and record duration of a behavior is to use a stopwatch or, if this is not possible, a watch with a second hand. As discussed previously, as with all behaviors, it is important that the behavior being measured with duration be accurately defined with a clear beginning and end so that the observer knows when the record should begin and when it should end.


Latency

The elapsed time between the instruction and the time the child initiates the behavior (e.g., how quickly the child initiates playing with a toy once it is presented). The way this is measured is by beginning timing once a cue is presented and continue timing until the child begins to correctly respond to the cue. A common example where latency is used is in school, when a teacher might be interested in learning how long it takes a student to begin work after she gives a direction to begin working.

Momentary Time Sampling

Similar to interval recording, momentary time sampling provides an estimate of behavior occurrence, but in this case, the behavior is only scored at the end of a interval of time. Using this procedure, observers simply check whether a behavior occurred precisely at the end of each interval (e.g., at the 10th second of a 10-second interval). Scores are calculated as percentages of the total number of observed intervals.

In addition to direct measurement strategies, a number of less formal and indirect measures may be of use when attempting to monitor a child’s performance.

Indirect Measurement

In addition to direct measurement, a number of informal data collection strategies exist that allow a child’s team to monitor his/her progress. Though they typically are not as precise as direct measurement, the following strategies are often useful in helping a child’s team monitor outcomes. In many instances, these strategies are easier to use and can be implemented throughout the day even by the busiest of individuals (e.g., teachers).

Below are some indirect ways to measure the child’s behavior or use of the skill. These forms provide a mechanism for recording the child’s behavior or use of a skill with less accuracy than direct measurement. However, they are time efficient and easy for teachers to use and provide some data that are meaningful and interpretable.

Click here for example (average aggression)
Click here for example (play behavior)
Click here for example (average duration)
Click here for example (peer interaction)

Daily Log

Although there is a wide variety, daily logs are general estimates of the child’s performance over a large period of time (e.g., the morning, the entire day). Often used by teachers, daily logs may note that whether the child had a “good day” or might rate a child’s performance along a 5-point scale using smiley faces.

Click here for example (Amy’s Difficulties)
Click here for example (Ben’s Playtime)

Incident Record

Incident records are descriptions of specific events, such as when a child engages in an incident of challenging behavior (e.g., biting another child, having a tantrum). While incident records describe the challenging behavior, (e.g., when it occurred, how intense it was, and what happened as a result), they do not describe anything other than the specific event.

Permanent Product

Permanent products are samples of a child’s work, such as artwork, a worksheet, or something the child creates. When collected together, permanent products allow a support team to observe a child’s progress toward developing particular skills such as those specified in a curriculum.


Portfolio Assessment

Portfolios are collections of permanent products that provide a detailed description of a child’s progress toward achieving specific skills. Examples of portfolios include photographs of their completed block designs, samples of artwork, photographs of dramatic play schemes, videotapes of play or instructional engagement, and audiotapes of language samples.

Task Analytic Recording

This is used when measuring a child’s accuracy for each step of a fixed skill sequence (e.g., brushing teeth, getting dressed, putting toys away, completing an academic task). The measurement process begins by constructing a task analysis or listing the individual behaviors that constitute the entire skill sequence. Below is such a list for washing hands.

WASHING HANDS
1. Approach sink
2. Turn on water
3. Place hands in water
4. Pump soap onto hands
5. Rub hands together
6. Rinse hands
7. Turn off water
8. Dry hands on towel

The data collection form that is used is based on the task analysis and includes all of the steps of the behavior and spaces for recording the child’s performance. Scores are expressed as the percentage of steps completed successfully.

Reviewing Progress

Once data are collected, they should be periodically reviewed by the behavior support team for a number of reasons: 1) to ensure consistent communication about the child’s progress; 2) to make any adjustments as needed (in the event that challenging behavior returns); and 3) to review progress relative to the long-term vision of the child and family.

When reviewing progress, the team should review both the child’s behavior support plan as well as the data itself. Reviewing the behavior support plan will help reorient everyone to the team’s vision for the child, thus making communication and interpretation of results easier. Once that is done, the team should carefully review the data that has been collected, looking for any particular patterns or trends (e.g., whether the behavior is occurring more or less on particular days or at certain times of day).

In some instances, a child may begin to exhibit challenging behavior after an intervention plan has been implemented for some time. In the event that challenging behavior returns, it is important to determine whether or not the behavior pattern is due to an extinction burst (i.e., brief instances when a child’s behavior gets worse before it gets better), as well as to examine events to determine if there are any new triggers than may predict the child’s challenging behavior. Another issue to consider when evaluating outcomes of support plans is the degree to which the plan is implemented with accuracy or fidelity. This is most important when extinction bursts occur—the more consistently a support plan is implemented, the more likely the extinction burst will resolve. On most occasions, support plans are evaluated for accurate implementation by using checklists that team members can use to determine which components were implemented.

Click here to see an example of a support plan fidelity checklist

Even with the most consistent implementation, there are occasions when behavior support plans require revision. The team may realize that a new trigger may be influencing the child’s behavior, such as a new staff person at the child’s preschool or a change in the child’s daily schedule or routine. When such instances occur, the child’s support team may elect to either add components to address new triggers or to conduct a new functional assessment and develop a revised behavior support plan.


References

Carr, E.G., Levin, L., McConnachie, G., Carlson, J.I., Kemp, D.C., & Smith, C.E. (1994). Communication-based interventions for problem behavior: A user's guide for producing behavior change. Baltimore: Paul H. Brookes.

Cooper, J. O., Heron, T. E., & Heward, W. L. (1987). Applied Behavior Analysis. Upper Saddle River, NJ: Prentice-Hall, Inc.

Hieneman, M., Nolan, M., Presley, J., De Turo, L., Roberson, W., & Dunlap, G. (1999). Facilitator’s guide: Positive behavioral support. Positive Behavioral Support Project, Florida Department of Education.

O’Neill, R. E., Horner, R. H., Albin, R. W., Sprague, J. R., Storey, K., & Newton, J. S. (1997). Functional assessment and program development for problem behavior: A practical handbook. Pacific Grove, CA: Brooks/Cole.



Building a Behavior Support Team | Person-Centered Planning | Functional Behavioral Assessment | Hypothesis Development
Behavior Support Plan Development | Monitoring Outcomes | Synthesis of the Research | Case Studies

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