managing the behavior of children with autism in inclusive classrooms
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Managing the Behavior of Children with Autism in Inclusive Classrooms. Brian A. Boyd, Ph.D. Frank Porter Graham Child Development Institute University of North Carolina Inclusion Institute, Chapel Hill, NC. Overview of Presentation. Characteristics of Autism & Problem Behavior - PowerPoint PPT PresentationTRANSCRIPT
8/2/2007 1
Managing the Behavior of Managing the Behavior of Children with Autism in Children with Autism in
Inclusive ClassroomsInclusive Classrooms
Brian A. Boyd, Ph.D.Frank Porter Graham Child Development Institute
University of North CarolinaInclusion Institute, Chapel Hill, NC
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Overview of PresentationOverview of Presentation
Characteristics of Autism & Problem BehaviorManaging Problem BehaviorPreventing problem behaviorReplacing problem behaviorResponding to problem behaviorSummary & Questions
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What is Autism?What is Autism?Autism is a neurodevelopmental disorder Autism is the second most common developmental
disability4-5 times more prevalent in boys than girlsOccurs on a behavioral continuum 75-80% of individuals have mental retardation 15-20% have average or above average intelligence
IQ HI
LO
SymptomsMild
Severe
AgeDimensions of Autism
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Characteristics of AutismCharacteristics of Autism
Social Communication Repetitive Behavior
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Types of Problem Behavior Types of Problem Behavior Associated with AutismAssociated with Autism
Social DifficultiesEscape/refuse social interactionInappropriate initiation strategiesCommunication DifficultiesRepetitive question askingInappropriate comments to strangersRepetitive and/or Problem BehaviorRepetitive hand flapping or object useAggression or SIB
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Usual Intervention StrategiesUsual Intervention Strategies
Context
Observable Behaviors
Characteristics of Autism
Observable Behaviors
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Re-thinking Problem Behavior in Re-thinking Problem Behavior in AutismAutism
•Not socially interacting
•Lack of social motivation
•Aggressive towards peers
•Lack appropriate social initiation strategies
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Re-thinking Problem Behavior in Re-thinking Problem Behavior in AutismAutism
•Need sensory input
•Repetitively rocks or hand flaps
•Repetitively dumps or pours objects
•Lack appropriate pretend play skills
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What Makes Inclusion Difficult for What Makes Inclusion Difficult for Children with Autism?Children with Autism?
Peer interaction
Learning via peer modeling
Emphasis on verbal communication
Environmental distractions
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What Makes Inclusion Possible for What Makes Inclusion Possible for Children with Autism?Children with Autism?
Our ability to put the appropriate supports into place
Our ability to manage problem behavior
Respond
Replace
Prevent
Managing Problem Behavior Pyramid
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Preventing Problem BehaviorPreventing Problem Behavior
1. Arrangement of Classroom Environment
2. Predictability of Classroom Activities
3. Appropriate Behavior Communicates
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1. Arrangement of Classroom Environment
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What is Classroom What is Classroom Arrangement?Arrangement?
Physical set-up / organization of the classroomIs the classroom set-up in a manner that cues
appropriate behavior?Availability of appropriate classroom
materials and toysAre materials & toys developmentally appropriate?Learning environmentAre distractions minimized & environment
engaging?
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Things to Think About When Things to Think About When Physically Arranging the Physically Arranging the
ClassroomClassroomCharacteristics of the child What are his / her social, communication, & play skills? Is the classroom structured for the child who has the
most intense needs?Well-defined activity centers Physical boundaries? Additional centers (e.g. sensory, independent work)?Availability of developmentally and age-
appropriate play materials Cause and effect toys or ones that are easier to
manipulate? Sensory-based toys?
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Additional Questions to Additional Questions to ConsiderConsider
Physical Environment & Classroom StructureIs there a fluid traffic pattern in the classroom?Does the classroom have learning centers?Is there structure and organization for seated
activities?How structured is the unstructured play and
physical activity?Is there adequate teacher supervision? (e.g.
teacher-to-child monitoring; zone monitoring)?
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Additional Questions cont’dAdditional Questions cont’d
Toys and MaterialsAre the toys and materials
developmentally appropriate?Are there enough toys and materials?Are toys and materials organized and
accessible to the children?Are the children’s preferences included
in the choice of toys and materials?
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Additional Questions cont’dAdditional Questions cont’d
DistractionsAre distractions kept to a minimum (e.g.
phones, intercom, and teacher traffic)?Are learning areas visually distracting to
the children? Is there an appropriate level of noise in
the classroom?
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Additional Questions cont’dAdditional Questions cont’d
Learning EnvironmentAre learning opportunities organized
and structured throughout the day?Does the teacher have a daily lesson
plan? If so, is the plan followed?
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2. Predictability of Classroom Activities
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What is Classroom What is Classroom Predictability? Predictability?
Classroom rituals & routinesHow predictable are they?How can we make them more predictable?
Classroom schedulesAre classroom daily schedules available
(“between-activity” schedules)?Are activity schedules available (“within-
activity” schedules)?
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Rituals, Routines and Challenging Rituals, Routines and Challenging BehaviorsBehaviors
Rituals and routines (R & R) provide stability and consistencyR & R communicate values such as
friendship, caring, or responsibilityR & R serve as rule remindersR & R create a sense of community
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Using Rituals and RoutinesUsing Rituals and Routines
Transition times Hello/Good-bye SongAs a rule reminderCriss-Cross ApplesauceTimes of crisisBreaking the coercive pattern & redirectionAs often as you wantFun!
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Building Routines:Building Routines:First-Then Contingency SystemsFirst-Then Contingency Systems
First ThenFirst Then
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SchedulesSchedules
Daily schedules should provide consistency for the children
Daily schedules should follow a “natural ebb and flow” to encourage appropriate behavior
Daily schedules should become “routine” and predictable for the children (Colvin & Lazar, 1997).
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Daily Visual Schedules Daily Visual Schedules “Between Activity”“Between Activity”
Photographic or picture schedules provide concrete, visual cues of the scheduled routine (Massey & Wheeler, 2000).
Changes to the schedule or special events (field trip, visitor, substitute teacher) require specific photos or pictures to cue children.
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Types of Visual SchedulesTypes of Visual Schedules
Object schedule
Photo schedule
Line drawing schedule
Written word schedule
Technology-based schedule (e.g. PDA)
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““Within” Activity SchedulesWithin” Activity Schedules
“Between” activity schedules take the child from place to place in the classroom (e.g. circle to snack)
“Within” activity schedules tell the child what to do once they get to the place
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Things to Think About when Things to Think About when Creating a ScheduleCreating a Schedule
What type of schedule should you use?
How is the schedule arranged (top-down v. left-right)?
How much information to include on schedule?
How to introduce flexibility into schedule?
Does everyone’s schedule look the same?
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Other Preventative VisualsOther Preventative Visuals
Use of Other “Helpful” Visuals
Hand prints
Foot prints
Wait (visual timer)
“Finished” or “All done” basket
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3. Appropriate Behavior Communicates
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Challenging BehaviorChallenging BehaviorCommunicatesCommunicates
Children engage in challenging behavior because “it works” for them
Challenging behavior results in the child gaining access to something or someone (i.e., obtain/request) or avoiding something or someone (i.e., escape/protest)
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Communication of Children with Communication of Children with AutismAutism
Children with autism need…
Means to communicate• PECS, language, written words, AAC
Motivation to communicate• Early, appropriate communicative attempts
should center around and result in access to powerful and natural reinforcers
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Putting Prevention into Putting Prevention into PracticePractice
Think of 1 child with or without autism in your classroom who exhibits problem behavior
Write down 1 prevention strategyArrangement of classroom environmentPredictability of classroom activities (routines &
rituals)Appropriate behavior communicates
Sharing Time
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Managing Problem Behavior Managing Problem Behavior PyramidPyramid
Respond
Replace
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Basic Behavioral PrinciplesBasic Behavioral Principles
Stimulus (S)/
Antecedent (A)
Response (R)/
Behavior (B)
Reinforcer (R)/
Consequence (C)
Transition time TantrumAllow child to stay in same activity
Behavioral History
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Basic Behavioral PrinciplesBasic Behavioral Principles
ReinforcerIncreases Behavior
PunisherDecreases Behavior
PresentFollowing occurrence of behavior
TangibleAttention
Positive
Aversive consequence
RemoveFollowing occurrence of behavior
Aversive condition (e.g. difficult task)
Negative
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Basic Behavioral Principles Basic Behavioral Principles (cont’d)(cont’d)
Setting Event–event that occurs at another time in the child’s environment that increases the likelihood the child will engage in challenging behavior. Setting events serve to “set the child up” to have challenging behavior.
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Some Potential Setting EventsSome Potential Setting Events
Change in MedicationsLack of SleepHungerArgument with ParentUnpredictable EnvironmentLittle Forewarning of TransitionsPresence of Certain PeopleOthers??
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Guiding Behavioral PrinciplesGuiding Behavioral Principles
1 Vast majority of appropriate and inappropriate behaviors are learned.
2 Problem behaviors are related to the context in which they occur.
3 Problem behaviors serve some function for the student.
4 Effective interventions are based on a thorough understanding of the student, the context, and the function of the problem behavior.
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What are the What are the Functions of Behavior?Functions of Behavior?
Individual’s engage in problem behavior for two basic purposes: To “obtain” something in their environment To “escape” something in their environmentWhat do we obtain? Tangible items (e.g., toys, access to remote control) Attention (e.g., from peers, parents, teachers) Internal sensory consequences--”it just feels good” (e.g.,
deep tissue massage, visual stimulation)What do we escape? Aversive situations (e.g., tasks, demands) Internal sensory consequences--”it doesn’t feel good”
(e.g., headaches)
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Let’s Play Guess that Let’s Play Guess that FunctionFunction
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AmirAmir
Amir, a 3 year old with autism, has a temper tantrum when he sees another child in his class with a Sponge Bob toy. The teacher has to say “You can’t have that toy, it belongs to someone else.” Amir continues to cry and tantrum, becoming very disruptive. Typically, class peers say to the teacher “I’ll share my toy with Amir.” The teacher agrees. Amir takes the toy and immediately stops the tantrum.
____ ____ ____ ____ ____ ____ ____ ____8 letter word
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SharifSharif
Sharif is a kindergartner with high functioning autism. Sharif is very bright and knows the answers to many of the teacher’s questions but has difficulty waiting his turn, raising his hand, and speaking in a normal tone of voice. He is constantly talking out of turn in class. The teacher finds this very disruptive to her lessons. When Sharif blurts out the answer, often the teacher responds “That is right Sharif, but let someone else have a turn.” When the teacher says this, Sharif blurts out another answer.
____ ____ ____ ____ ____ ____ ____ ____ ____9 letter word
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HoyeonHoyeon
Hoyeon, a 6 year old girl who has autism, swings high & fast on the outdoor swing set incessantly during recess. Occasionally, children in the class approach Hoyeon on the playground, but she either pushes them away or doesn’t respond. Eventually, they stop approaching her. When the teacher suggests to the other children that they might play with Hoyeon, the children say that Hoyeon doesn’t want to play and continue to play with each other. Hoyeon continues to engage in this behavior daily taking no notice of the other children.
____ ____ ____ ____ ____ ____ ____ 7 letter word
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Replacing Problem BehaviorReplacing Problem Behavior
To replace problem behavior you want to make it
Irrelevant, Inefficient,
and Ineffective.
(O’Neill et al., 1997)
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Replacing Problem Behavior Replacing Problem Behavior cont’dcont’d
Problem behaviors are irrelevant whenChild doesn’t need to escape anymoreChild has access to positive events more commonly
Problem behaviors are inefficient whenAlternative behavior is availableAlternative behavior is taught
Problem behaviors are ineffective whenProblem behavior NO LONGER works--it does not get the child what they want to obtain or what they want to avoid.
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Setting Events
Triggering Antecedents
Desired Alternative
Problem Behavior
Acceptable Behavior
Maintaining Consequence
Maintaining Consequence
Setting Event Manipulations
Antecedent Manipulations
Behavior Teaching
Consequence Modifications
INTERVENTION PATHWAY
SUPPORT PLANNING
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Behavior Support Plan Behavior Support Plan Components:Components:
Prevention Strategies Modify setting events and antecedents (i.e.,
triggers) to reduce the likelihood that the problem behavior will occur and increase the likelihood that an appropriate alternative skill will be used.
Teaching Strategies Teach the appropriate alternative skill.
Consequence Strategies Maximize the use consequences to strengthen
the use of appropriate skills and reduce the occurrence of problem behaviors.
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Design a Behavior Support Plan: Design a Behavior Support Plan: Preventative StrategiesPreventative Strategies
AKA: Make the problem behavior irrelevant
What modifications to the environment (academic, social, physical)
may PREVENT the problem behavior?
What adjustments will make the problem behavior unnecessary?
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Examples ofExamples of Preventative Preventative StrategiesStrategies
Increase the effectiveness of instruction for this child(Direct Instruction, Small group or Individualized Instruction)
Increase academic skill levels(Ongoing assessment to ensure instructional match & success)
Modify the curriculum(Interests, preferences, choice, sequence)
Modify the demands (Quantity, difficulty, presentation, alternative tasks)
Clarify the expectations and make environment predictable(Use of schedule, charts w/ visual cues of steps)
Reorganize the physical & interaction setting(Use physical boundaries, pair or independent seats, change
seating of students)
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Antecedent/Setting Event Antecedent/Setting Event StrategiesStrategies
Remove a problem event.
Modify a problem event.
Intersperse difficult or unpleasant events with easy or pleasant events.
Add events that promote desired behaviors.
Block or neutralize the impact of negative events.
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Design a Behavior Support Design a Behavior Support Plan: Teaching StrategiesPlan: Teaching Strategies
AKA: Make the problem behavior inefficient
What skills can be taught to the student that:
1) will meet the same need, or function, as the problem behavior,
AND
2) will provide access to the desired outcome as “efficiently” as the problem behavior?
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Alternative Skills to be Alternative Skills to be TaughtTaught
Replacement Skills: One-to-one replacement skills that serve the exact function as the problem behavior.
General Skills: Broad skills that alter problem situations and prevent the need for problem behaviors.
Coping and Tolerance : Skills that teach students to cope with or tolerate difficult situations.
(Bambara & Knoster, 1998)
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Replacement SkillsReplacement SkillsMatch Skills to FunctionMatch Skills to Function
Obtain: Attention, Activity, ObjectsProvide choices or preferencesFollow schedule & participate in routinesRequestInitiate interaction or gain attentionSelf-manage within activitiesWork toward delay of reinforcementUse first-then contingency systemOthers??
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Replacement SkillsReplacement SkillsMatch Skills to FunctionMatch Skills to Function
Avoid / Escape: Activity, Attention, DemandsUse schedule or checklist to self-manageSet work goalsProvide preferences or choiceRequest and take breakParticipate in steps or portion of routineRequest or seek helpOthers??
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Communication SkillsCommunication Skills
How to ask for or signal for:
help a breakinteraction attentiontime alone reduced demandsmore time alternative assignmentchoice opportunity to move aroundsensory input
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General SkillsGeneral Skills• Academic Skills• Use of Technology – hi and/or low tech • Organizational Skills • Independent Leisure or Play Skills• Vocational Skills
• Social Interaction Skills-Initiate and respond to interactions-Make friends-Participate in cooperative activities
(Janney & Snell, 2000)
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Self-Management or Coping Self-Management or Coping SkillsSkills
Name & Recognize EmotionsUse of Emotion MeterDeep BreathingMuscle RelaxationPhysical Activity Stress Relief
Relaxation Techniques
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Design a Behavior Support Design a Behavior Support Plan: Consequence Plan: Consequence
StrategiesStrategiesAKA: Make the problem behavior ineffective
What can I do to ensure that:
1) the problem behavior does not result in access to the desired outcome,
AND
2) the alternative behavior does result in access to the desired outcome?
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Important Questions to Think Important Questions to Think about in Assessment of Problem about in Assessment of Problem
BehaviorBehaviorSetting events & / or Antecedents Can I remove, neutralize, or modify ones for problem behavior
or put other ones in place that promote appropriate behavior (irrelevant)?
Behavior What replacement or alternative behavior should I teach that
will be as efficient (match to function, general skill, coping skill)?
Consequences What typically comes after the problem behavior now (what’s
the potential reinforcer)? What can I do to ensure that reinforcer no longer follows
problem behavior but rather appropriate behaviors (effective)?Episodes of Problem Behavior How can I respond differently?....Current strategy is not working
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Name: Observer: Date:General Context: Time:Trigger (Setting Event and/or Antecedent):
Challenging Behavior:
Maintaining Consequence:
POSSIBLE FUNCTION:
Observation CardObservation Card
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Activity/Routine MatrixActivity/Routine Matrix
Time/Activity Request HelpArrival √ CubbyPlanningCenters √ Toys;
computerClean-up √ SprayWashing HandsSnack √ MilkOutside Play √ Slide; toy
cabinetWashing HandsSmall Group √ Open
container
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Responding to Problem Responding to Problem BehaviorBehavior
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Managing Problem Behavior Managing Problem Behavior PyramidPyramid
Respond
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Consequence or Response Consequence or Response StrategiesStrategies
Don’t sweat the small stuff!!! Non-response or minimize response to
problem behaviorRedirect to use alternate skillReinforce use of alternative behavior
(immediately & consistently)Use natural or logical consequencesMaintain respect for student
(Janney & Snell, 2000)
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Monitoring ProgressMonitoring Progress
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Evaluating a Behavior Support Evaluating a Behavior Support PlanPlan
Measuring Progress - What Information to Collect:Increases in use of alternative skills
Reductions in occurrence of problem behavior
Positive side effects (e.g. improved grades, increased attention, peer acceptance)
Improvements in consumer satisfaction (e.g., student, family, staff, and others)
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Evaluating a Behavior Support Evaluating a Behavior Support PlanPlan
Measuring Progress - How to Collect InformationInterviews (e.g., teachers, students, parents,
service providers)
Informal and anecdotal reports (e.g., communication logs with parents, teacher progress notes)
Rating scales (e.g., student effect, social scales, opportunity for choice)
Natural documents (e.g., report cards, incident reports, medical records, placement records)
Direct observation (e.g., frequency counts, measures of duration, observation logs)
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Re-CapRe-Cap
Context
Observable Behaviors
Characteristics of Autism
Respond
Replace
Prevent
Re-Thinking Problem Behavior Managing Problem Behavior
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Re-cap Re-cap
IrrelevantAntecedents
InefficientAlternative skill
IneffectiveAccess to reinforcer
1. Arrangement of Classroom Environment
2. Predictability of Classroom Activities
3. Appropriate Behavior
Communicates
Preventing Problem Behavior Replacing Problem Behavior