Ariana DymerskiSped 471

Final Project

Student Description:

Sam is 21 years old and is a student at the Young Adult Program in Champaign. He

receives functional life skills lessons and participates in community-based instruction. He

is diagnosed with an intellectual disability. Sam has poor gross and fine motor skills,

causing his movements to be very abrupt and uncoordinated. During the day, Sam may

become frustrated or excited while performing an activity, causing him to engage in the

physical behavior of placing his thumb in his mouth. He may bite his thumb with his teeth

or suck on the thumb with his lips. The thumb is injected from the tip through the first

knuckle. This is a problem behavior because it is not age appropriate for a 21 year old to

place appendages in their mouth and such behavior may impede his ability to maintain a

job after he graduates due to sanitary concerns. This behavior occurs throughout the

course of day, while at school and out in the community.

Operational Definition: Throughout the course of each activity of the day, Sam inserts his

thumb from the tip to the knuckle into his mouth.

Examples: Student places teeth around knuckle of the thumb

Student surrounds the knuckle of thumb with lips

Nonexamples: Student places tip of thumb on outside of lips

Student places whole thumb on cheeks

ABC Observation Summary

During the observation times, Sam repeatedly engaged in inserting his thumb into

his mouth after conversing with an adult. Often times the adult in the scenario would

respond by demanding that Sam takes his thumb out and get back to work. However,

within the same half hour observation time, Sam would go back to inserting his thumb into

his mouth several times to cope with the current conversation he was having with an adult.

The consequences that occurred after Sam put his thumb into his mouth shifted in how the

different adults would respond. When the teacher worked with him, she would

inconsistently use a behavior management system of giving him strikes every time she

noticed the thumb in his mouth and when she remembered to respond with a strike. When

the paraprofessionals were working with the student, they would use direct demands and

threats to insist that Sam stop the behavior. From these observations, I discovered that

Sam enjoys talking with adults and uses sucking his thumb as a means of repeatedly

gaining attention from adults. As of right now, no replacement behavior is being taught to

the student and since no consistent behavior management system is being used with

consequences he should be aware of, he will continue to engage in the thumb sucking to

meet his conversational means.

Functional Assessment Interview Summary

For the interview, I spoke with the special education teacher, Lindsay Corum, and

the paraprofessional who works with him the most, Gerry. During the interview, the

teacher and paraprofessional agreed that the student struggled with using thumb sucking

to gain adult attention or to self-stimulate. They also noted that the student engaged in

these behaviors while he was among several adults. Thumb sucking is often paired with

another physical behavior of loud clapping, loud humming, jumping, or chair rocking.

Several adults immediately reprimand Sam when he engages in these pairings of behaviors.

Through a discussion between the teacher and paraprofessional, they figured out why the

student was performing these behaviors. They finally agreed that adult attention always

occurred right after the behavior, making it a sought after response for Sam. This interview

determined that Sam usually always pairs the thumb sucking with another physical action

and uses these behaviors to gain more adult attention during transition times at the

beginning, middle, and end of the day.

Functional Assessment Observation Summary

Revised Summary Statement: When Sam is performing demanding tasks at the beginning

of the day, during lunch, and at the end of the day among several adults, he will insert his

right thumb into his mouth alongside a physical activity of chair rocking, loud clapping, or

jumping to gain adult attention.

In the summary statement, clarification was made to when the transition activities

occur that upset the student: being at the beginning of the day, during lunch, and at the end

of the day. Also, the addition of Sam performing demanding tasks was included because

these transition times require Sam to complete items on his schedule in order to prepare

for the next activity. During the observation, the student frequently engaged in the

behaviors during the 15-minute intervals. These times were demanding, yet allotted for

conversing with the adults present. He enjoys adult company very much and when several

adults are present, he wants to converse with all who are at the table. However, when the

student was alone at the table, he did not perform any inappropriate behaviors. This

shows that adult conversation and attention, both motivates him to perform all tasks as

well as to engage in inappropriate behaviors. Due to the popularity of the student, several

adults want to converse and interact with the student, causing behaviors to occur more

rapidly when he is among several adults at the school site.

Data Collection Technique and Rationale

For data collection, frequency event recording was used. The student should be

observed in half hour sessions, broken into 5-minute increments. These increments are to

be recorded in the Start and Stop columns. During each 5-minute increment, the observer

is to put an X in the Occurrences column every time they see the student perform the

behavior specified on the sheet (Behavior – Thumb sucking-Throughout the course of each

activity of the day, Sam inserts his thumb from the tip to the knuckle into his mouth). At

the end of the half hour session, record the total X’s marked for each 5-minute increment.

Underneath the last 5-minute increment total recorded on the sheet, put the total for the

entire half-hour session.

This type of data collection will be used because the number of times the student is

thumb sucking is the most important aspect of the behavior. The goal of the intervention is

to decrease the number of times the student is observed with his thumb in his mouth.

Frequency recording will allow the observer to determine the current habits of the student

and in the future, determine if a decrease is occurring over the course of the intervention.

Inter-observer Agreement (IOA)

Prior to observations, the special education teacher was trained in the operational

definition of the target behavior, addressing both examples and non-examples. The special

education teacher was also trained in frequency event recording for each date and time

sessions that the student was to be observed. During each observation, the special

education teacher also recorded her observations along with the researcher on a separate

frequency event recording sheet. The results are as follows:

Total Frequency Event Recording IOA:27 X 100 = 96%28

Interval-by-Interval IOA:27 X 100 = 90%30

Occurrence IOA:21 X 100 = 91%23

Nonoccurrence IOA:8 X 100 = 80%10

Functional Analysis Manipulations

Hypothesis 1: When Sam is performing individual tasks in the presence of 2 or more adults,

he will insert his right thumb into his mouth alongside a physical activity of chair rocking,

loud clapping, or jumping to gain adult attention.

Hypothesis 2: When Sam is performing demanding tasks during the lunch transition period

in the presence of adults, he will insert his right thumb into his mouth alongside a physical

activity of chair rocking, loud clapping, or jumping to gain adult attention.

Due to the time of day when Sam is most likely to engage in thumb sucking that was

recorded during ABC recording, event recording, and functional analysis observation, it is

during the transition periods of the school day; morning preparation time when he is to set

up his schedule and begin the first item on the list, completing his hygiene; and the

behavior occurs during the first half hour of preparing to eat lunch when he is washing his

hands, setting up his mat to eat, and is cutting his food with the help of a teacher before

eating. During these transition times, several adults are present in the room due to all

students being present in the classroom also for transition. During this time, the adults are

quick to attend to Sam when he places his thumb in his mouth. This often leads to further

conversations with the adults because he has their attention and is able to ask questions

that they are willing to answer.

Due to the student’s wanting of social attention, an FAM could be conducted where

adults will immediately respond to the behavior and where adults will not respond to the

behavior. This will occur during the typical transition times he is used to engaging in. By

responding and not responding to the behavior, it can be determined whether Sam is using

the behavior to gain adult attention, or if it is being used for another function. Another

FAM that could be conducted is having Sam perform these transition periods in a one on

one setting, where the adult gives consistent attention to Sam throughout the process. If

Sam still engages in thumb sucking, then he is using the thumb sucking for another

function; if he does not engage in the thumb sucking, then he is using this behavior to gain

adult attention when he is not receiving consistent attention among other students.

Another FAM that could be conducted is to observe Sam when he is not instructed to do a

demanding task during the transition time. This way, the hypothesis of gaining adult

attention can be tested during tasks that are demanding and tasks that are performed at

the student’s leisure during the transition times.

The functional analysis manipulation that will be put into place is a change in the

adult presence during transition times. Sam will be in the same location as he usually does

his transition times, yet the presence of only one adult will give him attention throughout

the activity. Event recording will occur during his lunch time transition from 11:00am-

11:30am, the time that was identified for the behavior to happen. Data will also be

collected during the transition times when 2 or more adults are present, the same times as

were observed for the observational recording. This will be the control time that the

manipulated observational time can be compared to. Using frequency event recording

during each transition time, the hypothesis of Sam gaining adult attention among several

adults will be tested. This will determine if the function of the behavior is adult attention

or for another purpose such as self-stimulating.

Results: The results show that during one-on-one settings with constant adult attention,

Sam did not engage in thumb sucking on both occasions. When Sam was observed during

the usual transition lunchtime among several adults, he was recorded with high frequency

having his thumb in his mouth. During the first session, he was observed 6 times with his

thumb in his mouth and on the second session, he was observed 7 times with his thumb in

his mouth. These results determine that the function of Sam’s thumb sucking is to gain

adult attention.

Preference Assessment

Hierarchy List: 1. Oreos2. Lay’s Potato Chips3. Cheez-its4. Ritz Crackers5. Banana6. M & M’s7. Apple

From the teacher and paraprofessional functional assessment interview, the list of items

was assembled based on the particular food items they said he preferred. The teacher and

the paraprofessional said that food was a major reinforcer for the student, making a

preference assessment on food applicable. The teacher and paraprofessional said he

preferred Oreos, Lay’s Potato Chips, Cheez-its, and Ritz Crackers. They also pointed out

that he liked some fruits and candy, so a banana, apple, and M & M’s were used for the

preference assessment. The preference assessment showed he preferred the particular

items that the teacher and paraprofessional said he did. The fruit and candy were

commonly chosen last and showed he did not prefer these items. These preferences could

be used as reinforcement objects because they are tangible, easy to allot time for, and are

age appropriate. Food was assessed because it is the only identified preferred item by the

student that is accessible at school.

References

Dwyer, K., Rozewski, D., & Simonsen, B. (2012). A comparison of function-based replacement behaviors for escape-motivated students. Journal of Emotional and Behavioral Disorders, 20(2), 115-125.

The purpose of this study was to evaluate the effectiveness of four different replacement behaviors through an alternating treatments design, evaluating the appropriate behavior to be chosen for the student. The results found the implementation of all four replacement behaviors to decrease inappropriate behaviors, yet the researcher chose the replacement behaviors that worked the most effectively in decreasing problem behaviors, alternating between ‘help’ and ‘break.’ Offering choices to my student will empower him to demand his own outcomes and encourage him to respond with more socially appropriate behaviors.

Gresham, F. M., Van, M. B., & Cook, C. R. (2006). Social skills training for teaching replacement behaviors: Remediating acquisition deficits in at-risk students. Behavioral Disorders, 31(4), 363-377.

The purpose of this study was to evaluate the effectiveness of social skills training on students with social skill acquisition deficits along with the effects of differential reinforcement of other behaviors during generalization and maintenance periods. The study found that the students had decreases in problem behaviors and increases in socially appropriate behaviors. The differential reinforcement of other behavior is useful for my student because it will result in teacher attention, the function of his problem behavior. Instead, he will learn to associate appropriate behaviors with meeting his need of teacher attention.

Joosten, A. V., Bundy, A. C., & Einfeld, S. L. (2012). Context influences the motivation for stereotypic and repetitive behavior in children diagnosed with intellectual disability with and without autism. Journal of Applied Research in Intellectual Disabilities, 25(3), 262-271.

The purpose of this study was to evaluate the environment that surrounds stereotypical and repetitive behaviors of students. The study found sensory enhancement to be a motivator of such behaviors as well as anxiety reduction during stressful situations like transitions. In observing my target student, it is noticeable that he demonstrates the repetitive behavior of thumb sucking during transition times when several adults are moving through the area and are conversing with the student. Being aware of such environmental considerations will influence the most useful replacement behavior to be selected.

Travis, R. W., & Sturmey, P. (2013). Using behavioral skills training to treat aggression in adults with mild intellectual disability in a forensic setting. Journal of Applied Research in Intellectual Disabilities, 26(5), 481-488.

The purpose of this study was to operationally define and observe target and replacement behaviors, as well as measure the treatment effectiveness through generalization and maintenance abilities of the students after receiving behavioral skills training. The study found the adult’s aggressive behaviors to decline and the replacement responses increased in response to the targeted stimuli. The use of a replacement behavior with generalization is applicable to my student, who uses thumb sucking to gain attention of adults. In order to provide the student with the same consequence of receiving adult attention, a more socially appropriate response will be taught to the student.

Intervention program:

An antecedent-based intervention will be put into place to prevent the thumb

sucking from occurring. For the transition time of the lunch period, Sam will perform all

demanding tasks with a one-on-one adult. The adult will accompany Sam for hand washing

and then will help Sam prepare his placemat and cut his sandwich. During this time, the

adult will be instructed to hold conversations with the student to meet his need of adult

attention. This environment and staff change will be useful because during the functional

analysis manipulation, this proved effective during the transition times. In earlier

observations, the student was not partnered up with one staff member and was constantly

seeking the attention of an adult when he did not know who was with him. So to prevent

Sam from looking for adult attention that was hypothesized as being the function of his

behavior, the environment will be structured so to attend to this behavioral need. Also, the

option cards that are used for the student’s alternative skill will be placed on the table at

the beginning of the transition period. This way, the skill is available for usage at the

beginning of the session and can be utilized by the student throughout the period.

Sam will be taught the alternative skill of choosing between two option cards; they

will read “Can we have a business meeting?” and “Can we eat in the other room?” Giving

the student a choice will make him feel in control of his environment, an important aspect

of adulthood. Sam enjoys feeling like a staff member and so the choice of asking for a

business meeting will be appealing to him and will result in having one-on-one

conversations with an adult when he is feeling the need of adult attention. The other

choice of eating in the other room will give him a quiet area where he can also hold a one-

on-one conversation with an adult. These choices meet the hypothesized behavioral need

of Sam thumb sucking to gain adult attention. Sam can relate using one of these cards to

gaining teacher attention that proves to be just as effective and efficient as thumb sucking.

He will be instructed to hold up the card to the adult he is partnered with that was

established during the antecedent portion of the intervention. This is a more socially

acceptable behavior for his age of 21 years old. Also, Sam can generalize these choices to

other activities when he wants adult attention. The cards will be used to teach making

choices outside of thumb sucking, eventually being faded out of usage to the student only

asking for a change in the environment and social set up.

There will be consequences associated with both thumb sucking and using the

alternative skill of choosing between option cards. If the student is caught thumb sucking,

all other adults in the room are instructed to not reprimand the student and leave the

consequences to the adult assigned to work with the student at that time. For thumb

sucking, the assigned adult will not reprimand the student for performing this

inappropriate behavior, but will instead use most-to-least prompting to teach the student

the alternative skill. Instead, the adult will verbally direct the student between choosing

one of the option cards; saying would you like to have a business meeting or move into the

other room to eat? along with a point to the cards. This prompting will occur for the first

two weeks of instruction or until the student performs the skill in 4 out of 5 trials. Then the

student will receive an indirect verbal prompt of what do you want to choose? and a point

to the cards. If the student does not make a choice, the teacher will perform a direct verbal

prompt with a point as was previously used for instruction. The student will stay in this

prompting level for 2 weeks or until the student performs the skill in 4 out of 5 trials with

an indirect verbal prompt. Next, the student will receive only a point towards the cards. If

the student does not choose a card, the prompting will move from an indirect verbal

prompt, and then a direct verbal prompt if the student still does not choose a card. The

student will stay in this prompting level for 2 weeks or until the student performs the skill

in 4 out of 5 trials with only a point to the cards. When the student chooses an option by

holding the card in the air toward the teacher, the teacher will reinforce the student by

saying “nice choice” and offering the student an Oreo. After the first two weeks of

instruction, the Oreo will be offered after every other instructional period. This will be the

reinforcement for the next two weeks and then will be moved to receiving the Oreo after

every third instructional period. This will be the reinforcement for the next two weeks and

then will be moved to receiving the Oreo after every fourth instructional period. After two

weeks with this reinforcement schedule, the Oreo will be eliminated as a reinforcement so

to fade dependence on an edible item to perform the appropriate behavior. The verbal

praise will remain throughout the instructional program because it is age appropriate and

receiving verbal acknowledgement of proper actions occurs for both students with and

without disabilities.

For assessment of thumb sucking, frequency event recording will occur every third

day. The teacher will not provide any prompting for making a choice, yet the choices will

be available for the student to choose from on the table. During the instructional periods,

the teacher will record if the student needed direct verbal prompting with a point, indirect

verbal prompting with a point, a pointing prompt, or was independent. By recording what

prompting systems the student required, patterns of either decreasing, increasing, or

unchanging prompting levels can be determined over the course of the intervention

program. These patterns will help determine if changes need to be made to the prompting

level or if the current system is moving the student towards independence. The teacher

will also tally how many times the student needed to refer to choosing an option. This will

indicate how many times the student put his thumb in his mouth and needed to use an

alternative skill. The sheet will be out in front of the student, who can gain reinforcement

from seeing the teacher taking data on his actions.

Recording Codes:DV – Direct VerbalIV – Indirect VerbalP – PointingI – Independent

Instructional Data Collection:Date: Date: Date: Date: Date:

I

P

IV

DV