Meme Hieneman, Tracy Raulston, & Laura Strobel 2017-12-15 10:43:22
CLICK HERE TO LISTEN TO AUDIO VERSION OF THE ARTICLE This is the fifth article in a series describing the process of positive behavior support. In this article, we will share strategies for ensuring your plan will work for your child and family and produce durable results. The previous two articles in this series described how to create a plan that includes proactive, teaching, and management strategies to help your child be successful in typical family routines. This article is about how to implement – or use your plan. It will cover how to improve the chances that your plan will be used consistently and effectively and how to gradually adapt strategies to help your child be independent successful in constantly-changing life situations. MAKING SURE YOUR PLAN FITS Well-designed plans (that include proactive, teaching, and management strategies that match the functions of your child’s behavior) are typically effective, but there are considerations that predict whether they will work across situations and for the long-term. Below are things to consider so you can ensure that the plan you develop fits well into your family life, is realistic, and produces sustainable change. Child Characteristics – Children are unique and respond differently to various approaches. It is important to consider your child’s social communication, cognitive, sensory, motor, and emotional characteristics as well as his or her preferences when choosing strategies. For example, some children may only need you to provide verbal instructions as a proactive strategy, while others will need text, pictures, or even photographs to help them understand. When selecting skills to teach, it is critical to align them with your child’s abilities and the circumstances that they regularly face. When choosing management strategies, you must provide reinforcement that is meaningful and motivating to your child. Environment and Resources – Whether a plan will be readily implemented is dependent on the physical and social environment in which it will be used. This means making sure necessary resources (e.g., materials such as visual supports or equipment) are available and the environment is arranged to support the plan. It also means that strategies are designed to fit naturally within typical routines, rather than being disruptive to natural life patterns. Plans are most sustainable when they do not create undue stress on family members and are easy to use given the circumstances. Caregiver Preferences, Skills, and Motivation – It is important to consider the capabilities and needs of everyone in a child’s life - including other parents, siblings, nannies/babysitters, grandparents, friends and neighbors, and so forth. The strategies need to be “doable” and acceptable by all of the people providing care to a child. Family members and other caregivers may require some explanation and training to adopt strategies. They may also benefit from incentives such as positive feedback for their efforts, especially when changes they are making are particularly difficult. Systems Issues – Children are members of families and participate in a variety of educational, recreational, and community settings in which there are certain expectations and limits. It is important that strategies are aligned with these ‘systems’. In some cases, plans may need to be adapted to fit the demands of the system or vice versa. For example, if particular routines or household rules are important to you, your child’s plan should support them. In the following video, you will hear Jack’s mother and sisters talk about how they have designed strategies to fit Jack’s needs, as well as participate in activities the entire family enjoys. ACTION PLANNING Because parents lead very busy lives and are often juggling lots of different tasks and priorities, it can be very useful to plan out how all of the steps in a plan will happen. Specifically, you should decide what you need to accomplish, when it will be done, and who can do it. You might need to gather resources, rearrange your environment or routines, teach other caregivers about the plan, and plan other supports that will allow you to use to put your plan in place and use it consistently. Examples of action plan items might include: INCREASING YOUR CHILD’S INDEPENDENCE OVER TIME When your child is learning a new skill, you use prompts such as explaining exactly what you want your child to do, showing examples or modeling skills for your child, and using gestures, or even physical guidance to help them succeed. To ensure your child does not become dependent on this support, it is important to fade prompts as soon as possible. There are different methods of fading prompts. The following diagram provides an illustration of this process: Your ultimate goal is to move from more “intrusive” prompts to those that are more subtle and natural, thereby maximizing your child’s independence. When your child is first learning new skills, you provide reinforcement immediately and consistently following the behavior. You give your child what they use words to request (even if prompted) - be it attention, an item, or a short break – right away. You follow each completed task with something highly motivating such as a treat or access to a toy or game and praise your child following each step. The ultimate goal, however, is that your child will perform skills without extra incentives. To achieve this, you must thin reinforcement over time. You may thin reinforcement by increasing your expectations, delaying access to reinforcement, or reducing the amount of reinforcement provided. For example, instead of offering a highly preferred item every time your child displays a desired behavior, you can provide a sticker or check mark. Once your child earns a certain number of these, he or she can have the item. You might begin to require your child complete one more step in the routine before receiving a break or tell your child that you are busy right now but will give them attention when you are finished. In this video, you will see how Emmit’s mother gradually increases her expectations regarding what and how much Emmit must eat while reducing the size of the candy provided as a reward. By carefully fading prompts and thinning reinforcement, you are setting up your child up for success while gradually increasing independence in family routines. Ensuring that your plan fits your child, family, and circumstances, engaging in careful planning to improve implementation, and ensuring that you are adapting your strategies to maximize your child’s independence are critical components of effective plan implementation. In the next and final article of this series, we will address how to monitor fidelity and outcomes to ensure that your plan is producing the behavior and quality of life changes you want. LISTEN TO AUDIO VERSION OF ARTICLE
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