Positive Behavior Support: An Inclusion Strategy
Stanley L. Swartz, Ph.D.
California State University
One of the major obstacles to the inclusion of children with disabilities in both school and the community, is behavior that is inappropriate and disruptive. For children with severe disabilities, behaviors such as tantrums, aggression, or self-injury are challenging beyond what regular education settings are prepared to handle. Families of children with severe disabilities are also looking for assistance beyond the traditional manipulation of consequences offered by most behavior management programs.
If we are to accomplish inclusion, it will be necessary not only to identify treatment methods that work, but ones that will be acceptable in the context of inclusive environments. The three concepts of social validity identified by Wolf (1978) are important considerations in reaching this goal. These are feasibility - are we able to use the strategy; desirability – are we willing to use the strategy; and effectiveness – does the strategy make a difference for the individual in increasing inclusion opportunities?
In other words, we need treatment strategies that both parents and teachers are able and willing to use and that make a real difference for the individual and their opportunities to participate in school and in the community.
Research on the efficacy of special education is such that the urgency of placement in regular education is a very real issue for many children with disabilities. Justification for placement in special education seem unwarranted without some compelling case for its value not only for academic purposes, but as a larger issue of acceptance and even lifestyle (Swartz, 1998). The case can be made that the only obstacle to the inclusion of most children with disabilities is our preparedness to accommodate their needs, or worse, our willingness.
An increasing body of research in the use of positive behavior support (PBS) has demonstrated that these strategies are highly effective for use with the behaviors presented by children with severe disabilities (Carr, Horned & Turnbull, 1999). In addition, PBS meets the various social validity criteria in most cases and facilitates inclusion of children with disabilities. Unlike traditional behavior management, which views the individual as the sole problem and seeks to “fix” him or her by quickly eliminating the challenging behavior, PBS views such things as settings and lack of skill as parts of the “problem” and works to change those. As such, PBS is characterized as a long-term approach to reducing the inappropriate behavior by teaching a more appropriate behavior, and providing the contextual supports necessary for successful outcomes (ERIC, 1999).
Effective behavior change must not only reduce inappropriate behaviors it must also teach suitable alternatives. These changes should not only help the child in the immediate environment, or the short term, they must also be important for their life after school, or the long term. The key concept of PBS was then determined to be to change a problem behavior, it is first necessary to remediate deficient contexts. Deficient contexts were found to come in two varieties, those related to behavior repertoires and those related to environmental conditions. Behavior repertoires means that the individual does not have the necessary behaviors to be successive. Communication skills, social skills, self-management are all found to be inadequate for the demands of their day-to-day existence, whether in school, home, or community. Environmental conditions means that the stimuli in any particular environment are not conducive to appropriate behavior for this individual and contributes to the emergence of problem behaviors.
In applying PBS, the research review completed by Carr and his colleagues found two categories of intervention: stimulus-based and reinforcement-based (Carr, et al., 1999). When environments are deficient it is when there are too few stimuli to support positive behavior and that changes in this environment are necessary as part of the effort to help children with disabilities exhibit more appropriate behavior. On the other hand, from a reinforcement perspective, the existence of positive behaviors competes with or makes negative behaviors unnecessary because the positive behaviors provide an alternative for accessing the available reinforcement. In sum, PBS tries to change the environment so that the conditions for appropriate behavior and its reinforcement are available and to teach appropriate behaviors as a substitute for accessing reinforcement in the environment.
Positive behavior support appears to be best suited for long-term change and is proactive to the extent that it attempts to teach behaviors and impact the environment that surrounds these behaviors. This is contrasted to aversive or punitive approaches that seem best suited to a crisis management mode. From the perspective of the family, and in keeping with the principles of social validity, PBS would seem to be the appropriate choice because of its good fit with a family environment. Parents are able to work with their children using techniques that are effective and at the same time part of a normal pattern of interaction. From the perspective of the school, PBS is a good match because of its suitability for use in inclusive settings and because it is primarily a teaching method. Positive behavior support is procedure more likely to encourage the inclusion of children with disabilities in regular classrooms.
Redirective Therapy was developed as part of a training program in a university clinic for parents and families of children with pervasive developmental disabilities (Swartz, 1994). Parents had reported that though some techniques currently available appeared to be effective, they were too harsh and too unusual as a pattern of parent-child interaction. They felt that the treatment became an aversive to both parent and child because of its intensity and that its suitability for the community or an inclusive school setting was an issue. The criteria used in the development of Redirective Therapy (RT) was that it must allow for a positive interaction between parents and their children and that it must be suitable for use in all settings. Using research in nonpunitive techniques (Donnellan, et al., 1998) the strategy focused on a simple pattern of redirection with teaching an appropriate behavior as the end goal. Similar in this regard to the strategy identified as differential reinforcement of alternative behavior (DRA), Redirective Therapy diverged by electing to use only social rewards. It was felt that since one of the primary goals for most children in the program was increased socialization, the use of social rewards would be the first important step in teaching social skills.
Therapists using RT were taught to interrupt the undesired behavior and redirect the child to an appropriate behavior. They were instructed to do this interruption in the least intrusive way possible (for example, a word or a gesture would be a preferable interruption to a physical cue). Social reinforcement (praise or touch, or both) would immediate follow the interruption and redirection. In this way, the concern about limited availability of reinforcement in the use of differential reinforcement of other behaviors (DRO) could be resolved. This pattern was repeated until the child stayed on the new task and exhibited an appropriate behavior. Parents reported that their good feeling about this strategy was that they could use it at home and on any trips into the community. In another words, it met both the social validity criteria of feasible (I can use it) and desirable (I will use it).
Carr, E.G., Horner, R.H., & Turnbull, A.P. (1999). Positive behavior support for people with developmental disabilities. Washington, DC: American Association on Mental Retardation.
Donnellan, A., LaVigna, G., Negri-Shoultz, N., & Fassbender, L. (1988). Progress without punishment. New York: Teacher’s College Press.
ERIC Research connections in special education (Winter, 1999). Positive behavior support. ERIC Clearinghouse on Disabilities and Gifted Education.
Swartz, S.L. (1994). Redirective therapy: Guidelines for use in school and home.
San Bernardino, CA: California State University.
Swartz, S.L. (1998). Inclusion of children with disabilities in regular school programs. In Z. Jacobo & M. Villa, Sujeto, educacion especial e integracion, Mexico: Universidad Nacional Autonoma de Mexico.
Wolf, M.M. (1978). Social validity: The case for subjective measurement, or how applied behavior analysis is finding its heart. Journal of Applied Behavior Analysis, 11, 203-214.