Promoting Independence in Individuals with Disabilities

By Karen Umstead, M.Ed. Board Certified Behavior Analyst
Beautiful Minds of Princeton
www.beautifulmindsofprinceton.com

beautifulminds@comcast.net www.beautifulmindsofprinceton.com 1

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 Who are you
A bit of data collection
 Administrators
 Direct Support Staff
 Behavior Analysts
 Parents
 Population served
 Adolescent
 Adult
 Disabilities
 Autism/Developmental Disabilities
 Multiple Disabilities
 Mental Illness
 SLD
 Other
 Areas you work in:
 Employment/Vocational
 Day Programs
 Supported living (supervised apartments, group homes)
 Community
 Familiar with applied behavior analysis (ABA)


Reality
Independence is a critical skill, especially in the
home, community, and in employment
Most individuals with disabilities are unable to
perform skills when professional support fades.*
Even if the skill is mastered independently, often
times it is not generalized or carried over to new
people objects, and settings. *
Independence should be lifetime goal.

* (Hume, Loftin, & Lantz,2009, p. 1329)

For Your Consideration
As you grew up, did you always want to live at home?
Did you want to be able to go the mall or out to eat
without an adult watching over you?
Did you want to get a job? Doing something you
liked? Or at least in a place that you liked?
When you started to do these things, how did you
feel?


Survivor: Independence Indonesia
Dropped by yourself in a non-motored boat and
cannot see land
You have assorted items in your boat
Everything is working and ok to use for activity
For now you cannot see anyone else

© BMOP 2011 www.beautifulmindsofprinceton.com 6

Barriers to Independence
Communication
Initiation*
Generalization*
Prompt Dependence*
Behavior


Consider your Client
Take time now to pick out a client that you want to
increase his/her independence
As we go throughout this workshop, consider each
area and how it may apply
By the end of the workshop, you should have an idea
on something to try next with your client


Communication
Expressive abilities
Articulation
Delays in processing
Receptive understanding


Initiation
Planning
Motor-preparing for/anticipating movement
Planning steps of activity or appropriate response
Processing Speed
Attention to relevant environmental cues/stimuli
Motivation-is it worth it to try and initiate?
Unclear expectations
Need to specifically teach, prompt, & reinforce this skill

* (Hume, Loftin, & Lantz,2009, p. 1330-31)

Generalization
Train and Hope
Overgeneralize
Take one skill and apply it to inappropriate
circumstances
Client learns hand motion for round and round and
starts to do that in other settings/times that it is not
appropriate
Faulty stimulus control
Target behavior comes under the restricted control of
an irrelevant antecedent stimulus
Client says red when he says a card with a bent edge

(Cooper, Heron, Heward, 2007)

Prompt Dependence
Over-reliance or dependence on adult support
Can be especially difficult when having 1:1 support
Client may not exhibit the behavior without some
form of a prompt
In some cases, clients will guide adults to prompt
them indicating the client considers it part of the
response
Also be aware of the client relying on adults for
reinforcement rather than delivering it themselves


Behavior
Inappropriate behavior
Lack of appropriate behavior
Can overlap with other barriers
More of a positivity or lack of desired behavior (e.g. not
typically inappropriate, but not greeting others at job)
Little to no motivation


Consider your Client
Consider the following and write it on your paper
What barriers to independence might be affecting
your client?
What specific elements of the barrier(s) exist?


Finding the Balance

Staff Support Independence


Communication
Never to old to start teaching/shaping
communication
Look at latency- teach to fluency (quick & correct)
Use of visual supports to communicate or understand
Finding means to communicate receptively
Can work on articulation goals or consider teaching a
way to ask people if they understand or a way to
augment communication with gestures/visuals
Technology can be very useful in facilitating all this


Self-Monitoring
Aspect of self-management
Mark down the occurrence or not occurrence of
behavior
May improve behavior by increasing self-focus on
behavior or aspects of one’s behavior

Target Behavior # of times

Asked someone if they needed 1111 1111 1111 111
help


Self-Monitoring
Consists of four steps
Choosing and defining target behavior (operational)
Deciding on system of self-monitoring
Identifying reinforcement
Teaching individual system of self-monitoring
Teaching self-management independence
Initially you may want to consider adding a bonus
and/or have individual check-in with adult
Gradually release to individual


Video Modeling (VM)
 VM involves watching a video demonstration and then imitating the
behavior of the model
 Models can be:
 Self (video self-modeling)
Positive self-review (PSR)

 Edit video clips to show client engaging in appropriate
behavior
 Edit video clips to show client showing inappropriate behavior
 Video feedforward
 takes skills client possesses and sequences them correctly

 takes skills client can do with prompts, and edit out the
prompts
 Peer, Adult, Point of View modeling (seeing through someone’s
eyes)


Video Modeling Greetings


Video Modeling Toothbrush


Video Modeling Towels


Video Modeling POV


Integrated Work Systems
Component of the TEACCH program
Visually organized space
Individuals independently practice skills that have been
previously mastered under the direct supervision of an
adult.
A work system visually communicates at least four pieces
of information to the client:
1. The tasks the client is supposed to do
2. How much work there is to be completed
3. How the client knows he/she is ﬁnished/progress
4. What to do he/she is finished?


Similar to activity schedules but…
Work systems do not require matching or
sequencing skills
Instead, work systems may use a ‘‘left-to-right’’ format
where clients complete all activities placed to their left
(in any order), and move them to ‘‘ﬁnished’’ location on
the right
Strong emphasis of teaching concept of finished as a
motivational tool
Requires well-organized and structured work space with
few distractions that compete for a client’s attention.


Some Research Results
Increase in on-task behavior (including
generalization not just during integrated work
systems)
Decrease in adult prompting
Generalization of skills from special education to
general education
Reducing latency between instruction


Strategy Use
Issues of planning, problem-solving, goal setting
Work on not only what but HOW
Strategies to consider teaching
Goal setting
Problem-solving (including what to do if 1st try fails)
Self-advocacy


Time/Prompting Aids
Time Timer
Visual representation of time
With and without beep
Stand alone or watch
Motivaider
Stand alone or clip on
Vibralite Vibrating Watch
Smartphones


Motivador
Stand-alone or clip on
Vibrating
Can be set for intervals
(seconds or minutes)
Fixed or Variable schedules
Duration and intensity of
vibration can be customized


Guidelines to Facilitate Generalization
Teach target behavior in natural setting
Train across individuals
Train in variety of settings
Quickly shift between artificial cues and
reinforcers to natural cues and reinforcers
Transition from CRF to intermittent
reinforcement
Increase delays in delivery of reinforcement
Reinforce generalization
(Zirpoli & Melloy, 1993)
(Alberto & Troutman, 2009)

Generalization
This is not an exhaustive list and there are more
strategies to consider
Introduce to Natural Maintaining Contingencies
Program common stimuli
Including typical features of the generalization setting
into the instructional setting
Teach loosely
Randomly varying noncritical aspects of the
instructional setting within and across teaching
sessions
(Alberto & Troutman, 2009; Cooper, Heron & Heward, 2007)

Training for Generalization
Train Sufficient Exemplars
 General Case Programming: emphasizes using sufficient
members of a class of stimuli to ensure that clients will
be able to perform the task on any member of the class
of stimuli
 Using Multiple Settings, Teachers, and Activities:
evidence that training in a variety of settings generalizes
the skills taught to novel settings
 Teaching the learner to respond to a subset of all of the
possible stimulus & response examples then assessing
the learner’s performance on untrained examples
(referred to as a generalization probe)

Training for Generalization
Use Indiscriminable Contingencies
 Employ thin intermittent schedules of
reinforcement
 Make it difficult for the client to determine when
contingencies of reinforcement are to occur.
Train to Generalize:
 Increase probability by reinforcing
generalization as a response class
 Lag schedule of reinforcement – teacher
provides reinforcement only for responses
that are different from the previous
response


Needs to Consider
Inadvertent prompts
Eye gaze
Slight gestures (hands, head)
Body language (orientation, leaning)
Over-preparing the environment (stimulus prompts)
Getting everything out for individual
Putting everything away for individual
Too helpful (time delays)
Jumping in immediately


Prompting
In this case we are discussing prompts given after an incorrect
response is made
This different than an Sd (usually a verbal command)
When initially teaching a skill, it may be appropriate to use a
most-to-prompting strategy.
With a client with prompt dependency issues, least to most is
recommended
Least-to-Most
 Written/Visual
 Gestural (e.g. pointing)
 Model (show the individual what to do)
 Faded Physical
 Physical


Verbal Prompting
In general, verbal prompts should only be used when
a verbal response is required.
Least-to-most
Written/Visual
Gestural (facial cues or expressions, tapping lips)
Faded verbal first sound
Faded verbal words
Verbal prompt


Three Term Contingency
Antecedent: what happens before the behavior
 Ex: teacher calls on student, demand (come here) is made, peer
pushes
Behavior: ALWAYS describe in specifics (like you’re
telling a blind person), only in observable terms
 NO: mean look YES: stared directly in other students eyes for 10
seconds with facial muscles tensed
Consequence: what happens after a behavior
 Ex: Student sent to office, Para says do your work, student laughs


Function of Behavior
Look at the function (why the behavior is occurring)
Four main functions
Attention
Escape/Avoidance
Sensory
Tangible (wants to get an item)


Competing Behaviors
Build plan around hypothesis statement
Identify desired and alternative behaviors
Work to make behavior
Irrelevant (antecedent)
Inefficient (teaching new skills)
Ineffective (consequence)
A way to brainstorm strategies to address the
problem behavior at different stages


Build a Competing Behavior Pathway

Desired
Behavior Maintaining
Consequence
Triggering
Setting Event
Antecedent

Problem
Behavior
Maintaining
Consequence

Replacement
Behavior


Other Considerations
Reinforcement- needs to be individualized and
appropriate
Allow for choice-making whenever possible
Consider individual preferences when appropriate
Take into account strengths and weaknesses
Find a way to measure if the intervention/plan is
working. Can’t just rely on anecdotal info


References
Alberto P. A, Troutman A. C. (2008) Applied behavior
analysis for teachers. 8th ed. Upper Saddle River, NJ:
Prentice Hall.
Cooper J.O, Heron T.E, Heward W.L. (2007) Applied
behavior analysis (2nd ed.) Upper Saddle River, NJ:
Merrill/Prentice Hall.
Hume, K., Loftin, R., & Lantz, J. (2009). Increasing
independence in Autism Spectrum Disorders: A
review of three focused interventions. Journal of
Autism and Developmental Disorders, 39, 1329-1338.
Doi: 10.1007/s10803-009-0751-2


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