ACCENT on Family Care Services, LLC
Helping Special Needs Children
 
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Article 9 is the law as it relates to managing behaviors of those who receive services with the Division of Developmental Disabilities. 

Article 9 Download

ACCENT trains and certifies in Article 9.  The Article 9 certificate stays with ACCENT because the training is free as a service to our employees and applicants of ACCENT,

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The following download contains information for parents and providers regarding how to document habilitation goals.  It also contains suggestions for parents to include in their child's Individual Support Plan.  Following this information can help to support the client's need for habilitation services.

Click here for information on documenting habilitation goals

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Click for info on teaching self-help skills.

Click for teaching how to wash hands.

Click for a Definition of Autism

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    We are continually updating and adding to the information on this page.
         
Teaching Skills using Positive Behavior Strategies
The individuals we work with not only need to learn new skills (how to brush their teeth, plan a nutritional meal, wash their clothes, etc.) but also need to develop more positive attitudes towards the people around them. They must learn to like themselves, develop a feeling of self confidence. They need to know that someone likes and cares about them. They must feel successful and be able to say, "Hey look what I did!" If they do not feel good about themselves, then teaching them new skills will seem to be nearly impossible.
The responsibility for helping the individuals we work with develop good feelings about themselves lies with the people who support them.   "As a person who provides direct support," you can accomplish this responsibility by developing a positive relationship with the individual by your words and actions, "I like you", "You are a worthwhile person", " I know you can do it."
We need to RESPECT AND VALUE the individuals we work with.  They have likes/dislikes, needs, wants, etc. just like anyone else. In order to identify these and help that person learn to fill them we must develop a relationship with that individual. Remember--We are here to help "each person" develop their potential as an individual (i.e., We don't build products.  We build relationships and relationships build people!!) Some of the tools we can use to do this are:
1.   CONCENTRATE ON THE INDIVIDUAL'S STRENGTHS:
      
       a. When you are with the individuals, talk about what they can do, don't dwell on 
           what they cannot do.
      
       b. What are their positive points?
      
       c. What can you and the individual do to further develop these positive points?
2. PRAISE THE INDIVIDUAL
Praise the individuals for the good things they do. Do not assume they know what they are doing is correct. Praise builds self-confidence. The more things they know they can do, the more they will try. Don't forget to praise attempts even if they are not successful--praise the fact that they tried. Use the individual's name when praising him/her. Let them know it is they, as individuals, you are praising. When you praise someone base it on his/her likes. Likes are the things a person chooses to do or have, that they are willing to work for, and will get obvious pleasure from (places, events, people, food, objects).
3. BE AWARE OF YOUR VERBAL AND NON-VERBAL ACTIONS:
Some of the strongest communication we give is through our non-verbal actions, (eye contact, gestures, body language, looks, expressions and body contact). People will pick up on these things and act accordingly.
                                      a. Are you warm, friendly, and interested?
                                      b. Do you yell at the individual?
                                      c. Do you look angry?
                                      d. Are you afraid of the individual?
                                      e. Do you look bored?
4. TREAT THE PERSON AS A PERSON:
      a. How many times do you find yourself giving orders saying, "Do this, Do that." or, maybe more frequently, "don't do that." Each time you do this, you are really telling someone they cannot do anything for him/herself and you are talking that person's control from them. No one can learn independence or self-confidence or trust if someone continually orders them around. It takes away the opportunity to build relationships with people.
       b. Try saying, "Could you help me with this? "I think this a good idea, how about you?"
       c. Give choices whenever possible. Don't we all like to have some control over our own lives?
       d. Never talk about an individual in front of him/her as if he/she isn't there. If you must discuss a person, involve him/her in the conversation with you.
       e. Never talk about an individual's shortcomings in front of other individuals present. Reserve any discussion for a time when others are not around or when the person can be involved in the discussion (problem solving)
       f. Never talk about an individual's problems or shortcomings you work with/for to any person who is not professionally involved with that person.
Use these tools to positively build relationships and you may be amazed at the outcome!                                                                                                                                                       
                          What is Applied Behavior Analysis (ABA)?
ABA uses positive reinforcements to increase desired behaviors.  A main componet of ABA is breaking tasks into smaller, more manageable components, which promotes increased success.  Following are teaching techniques that can facilitate ABA in teaching new skills.
Bonding or Pairing is what the teacher does at the beginning of the time with the child.  The teacher would start by engaging in an activity that gets the child's interest and enthusiasm and then gradually move to other activities. 
Reinforcements are anything a person is willing to work for such as privileges, a treat, awards, and especially praise.  Having a reinforcer can motivate the person and help them focus on the desired behavior. Typical children often do chores to earn allowance or privileges.  Things such as talking, dressing and eating that would not be "work" for a typical child can very hard work and stressful for a special needs child. When these basic skills are being introduced to the child, reinforcers are used.  The reinforcer should be given immediately following a desired behavior to increase the likelihood of the behavior occurring again. A variety of reinforcers should be used. Over time the frequency of receiving the reforcer can fade once the desired skill becomes mastered.
Prompting is any additional stimulus that increases the chances of a correct response.
Types of prompts: modeling, physical (pointing or gesturing), verbal, voice inflection, position proximity, or visual.  When introducing a new task, begin with the most obvious physical prompt.  Eventually scale the prompt down to more of a "hint" after the task has been practiced.  Always prompt well before the frustration level.  Be careful to give the child opportunities to answer without the prompts to avoid the child becoming prompt dependant.
Fading is a teaching technique that gradually reduces or withdraws the amount or method of assistance or prompts given to an individual.  This gives the individual the opportunity to become independent.
Discrimination is a strategy that teaches a child to discriminate when and where an event should happen and what the appropriate environment would be.
ex:  The caregiver is teaching the child to properly introduce himself to people.  The caregiver would want to also teach that the child does not introduce himself to strangers without the parent's consent.
Token Economy is a strategy where "tokens" are used as reinforcers/rewards.  Tokens may be check marks on a board, poker chips, points, stickers or small items.  After earning tokens they may be exchanged for items, activities or privileges.  Token economies should never require an individual to earn money or basic necessities that they are already entitled to receiving.
Errorless Teaching is used when introducing a child to a new concept.  An example would be; after teaching a child the color red the teacher would show the child the color red and ask, "What color is this?"  Then the teacher would immediately say "Red".  Over time the teacher would  delay saying the answer to give the child a chance to respond. 
Hand-over-hand is used when the teacher is helping the child get the concept of what is wanted.  If the goal is for the child to put one block on top of the other, to introduce the goal, the teacher would cup the child's hand in hers and with the child, place the block on top of the other.  If the goal is for the child to pick up the toys and the child understands what is wanted but is reluctant the teacher could do the same technique. If the child physically resists then another method should be used. This technique as well as any technique can never be done with anger or force on the part of the teacher.
Graduated Guidance is a teaching technique that "fades" the guidance of a task as the ability to perform the task increases.
ex:  The child is learning to sweep the patio. Physical guidance was needed.  The caregiver physically guided the child be providing a constant touch to his elbow.  As time went on, the caregiver used less and less touch.  Soon the child would sweep the patio without assistance.
Modeling  is when the teacher demonstrates what is wanted. The expectation is that the child will imitate what was done.  The provider's enthusiasm can help gain the child's interest. 
Chaining is a teaching technique that breaks a task into very small steps.  Each step is then taught in sequence.  Forward chaining teaches the steps from beginning of the task to the end.  Backward or reverse chaining teaches steps from the end of the task to the beginning.  This technique is good for repetitive tasks that can be worked on over time.
  ex:  Child is learning to brush his teeth, but he shows frustration trying to remember everything.  The caregiver breaks down the task into steps, such as picking up the toothbrush, wetting the brush, putting toothpaste on the brush, etc.  The caregiver starts with having the child pick up the brush.  When this is mastered, the next step is taught.  Then as step one and two are put together the child is ready to add step three.  Giving positive reinforcement will add encouragement and increase the child's interest in learning the task. 
Shaping reinforces efforts to get closer to a desired response.  When the task is introduced, any response that even vaguely resembles the desired response is reinforced.  After the response occurs with regularity, the expectation is stepped up to be closer to the desired response.
ex:  The child has a difficult time being in the same area as a group of people while learning new things.  Each time the child walks towards a group of people, positive reinforcement will be given.  Once he is doing this regularly, the child will need to get even closer to the group before the positive reinforcement is given.  Over time the child will be expected to get closer and closer to the group before he is given the reinforcement.
Environmental Engineering is a strategy that is usually the least aversive.  It involves taking clues from the environment and modifying the environment to resolve the current issues and prevent future occurrences of the same issue.
ex:  The child cries every time his mother prepares a meal making a stressful situation for both the child and his mother.  After some observation, it is noticed that the child's frustration seems to happen when his mother leaves his sight.  The living room sofa blocked the child's view of his mother.  With some rearranging of furniture, the child can see his mother, his crying stopped and he is able to play in the living room while his mother prepared meals.
Active Listening helps with expression of thoughts and feeling productively, avoiding inappropriate verbal or physical actions.  When a person is frustrated or mad (and expresses it physically or with yelling), this strategy may be effective.  The caregiver would engage the individual in conversation and actively listen to the feelings and thoughts being expressed.  The caregiver paraphrases back using action verbs.  Expression, empathy and validation of feelings make this a good initial approach.
Talking is a strategy to bring calmness to a situation.  This ideally is done more as a preventive measure rather than after a difficult situation arises, but can be used for both.  The caregiver should include discussion of the situation, the option/alternative choices the individual can make and the positive outcomes that come from the choice made.
Redirection redirects a person to a variety of options and choices and the person becomes involved in one of the choices.  Redirection can be helpful when a behavior needs to be changed.
Selective Attention is a strategy that minimizes the attention given to undesired behaviors and gives attention to functional behaviors.  This is very powerful.  By giving attention to a behavior it can be reinforced.  The first step is to recognize desired and undesired behavior.  When a desired behavior is occurring the caregiver should reinforce with verbal praise and acknowledgement that specifically addresses the behavior.  When an undesired behavior is occurring, the caregiver should give no attention to the individual, turn away and give attention verbally to someone or something else.  The caregiver should be aware of the reaction by the individual.  If this method is working, the caregiver may see the individual looking at or approaching the caregiver and decreasing the undesired behavior.  When any of these happen, the caregiver gives attention again to the individual by telling them that their current specific behavior is good.  Another strategy that works with this is modeling the desired behavior.
Bridging is a strategy used to move from one behavior to a more positive behavior.
ex:  The child flaps his hands when listening to music.  The caregiver teaches the child to clap his hands when listening to the music. The caregiver is giving the child opportunities to move or bridge from one less desirable activity to a more acceptable activity.  For an undesirable behavior to be successfully terminated a replacement behavior must be taught to take its place
Voluntary Time Out or Quiet Time is a teaching technique and strategy that either by request or choice an individual will go to a less reinforcing environment to relax or settle down.  After the child has calmed down for a few minutes, he/she should be ready to return to the original situation.  It also provides time to think about good choices.  No forced time outs are ever allowed.  This strategy is not used for a punishment, rather it is used to give the child the chance to redirect his energy and reflect on more positive behaviors.
Situational Support is a strategy to get the desired behavior by changing the environment.  By making elements of the environment conducive to the desired behavior, the better the results will be.
ex:  The child needs to clean his room.  The caregiver sits on a chair giving the child verbal direction and prompting him to pick up the toys.  The child does not respond until the caregiver joins the child in picking up the toys.
Generalization Activities is a strategy to develop activities that require little or no supervision or direction.  This gives the individual freedom to choose an activity when no structured activities are occurring.
ex:  The child is pacing around the room, twirling and interrupting others. The caregiver tried to redirect the child, but his behavior soon started again.  The caregiver realized that the child needs an activity that he could enjoy that did not need direct supervision.  A shelf with books and magazines was set-up.  The child now goes to this activity when the caregiver is busy.  His pacing, twirling and interrupting others has stopped.  The child seems to enjoy is freedom.
Relaxation Teaching  is a teaching technique to teach relaxation.  This typically may involve:
   * Teaching to tense and relax muscles and muscle groups in an orderly manner.
   * Verbal instructions given in a calm and soothing voice.
   * A quiet environment away from the other people and distractions.
Generalization  increases the child's knowledge across a variety of different environments and approaches.
Maintenance After the individual has learned a skill it is important to continue to review the skill regularly to keep up their knowledge of the skill. 
Incidental Teaching makes the most of opportunities in a natural setting. 
    
*Disclaimer:  The above collection of information is ACCENT on Family Care Services' interpretation of information that has come from experience, training and research. Most of the information comes from The State of Arizona's Division of Developmental Disabilities' Home and Community Based Skill Building Training Manual. This information is intended for the use of ACCENT and those associated with ACCENT.   This information is not conclusive and is not meant to take the place of information from professionals.  

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