Antecedent Interventions – If you can predict it, you can prevent it??

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Behavior Management

Stopping Behavior Before It Starts

Antecedent Interventions for Challenging Behavior

Charles L. Wood, Kerry W. Kisinger, Chelsi R. Brosh, Larry B. Fisher, and Reem Muharib

Mr. Smalley, a first-year special education teacher at Baker Elementary, has been struggling to manage his students’ disruptive and challenging behavior in his co-taught third-grade class with Ms. Marbury. One afternoon, Mr. Smalley and Ms. Marbury meet with the district’s behavior specialist, Ms. Sears, to discuss ways to improve their students’ behavior. “Let’s try stopping the problem behavior before it starts,” Ms. Sears suggests.

Many teachers have difficulty supporting students with challenging behavior. Students who shout out, are frequently off task, have a tantrum, or don’t follow directions can be disruptive and bring a teacher’s lesson to a halt. Other students may struggle to communicate their needs. As a result, these students may engage in challenging behavior to get what they want or to escape unpleasant environments or activities. Fortunately, there are evidenced-based practices for addressing challenging behavior. Some interventions help teachers stop problem behavior before it starts. These practices are called antecedent interventions (Cooper, Heron, & Heward, 2007). Three research-based antecedent interventions to prevent and manage students’ challenging behaviors are presession attention, high-probability request sequences (HPRS), and functional communication training (FCT). Prior to selecting an intervention, a teacher should conduct a functional behavior assessment (FBA; O’Neill et al., 1997) and a preference assessment (Cooper et al., 2007).

FBA

An FBA is used to understand why problem behavior occurs and can lead to more effective interventions. Teachers or other professionals can use an FBA to identify the function (i.e., what the student gets or gets out of) of a student’s challenging behavior. FBA involves two general approaches: indirect methods and direct methods. Indirect methods include interviews with or rating scales completed by others who know

the student well (e.g., other teachers, parents). The purpose is to gain insight into why the student may be engaging in the problem behavior (e.g., What does the behavior help the student gain? What does the behavior help the student escape or avoid?). Direct methods involve observing the student and documenting the presence of the challenging behavior. ABC (i.e., antecedent, behavior, consequence) recording can be used to look for patterns that can reveal the function of the student’s behavior. For example, an ABC observation might show that the student frequently gets teacher or peer attention for every shout or inappropriate comment made in class. In this case, the FBA can be used to develop an intervention to teach the student a new way to achieve the same outcome (e.g., getting attention). Readers are encouraged to visit the IRIS Center website (iris.peabody. vanderbilt.edu) or access text resources (e.g., O’Neill et al., 1997) for more guidance related to FBAs.

Preference Assessment

Another important consideration prior to developing and using a behavioral

the student with choices about activities or items. Identifying the student’s preferences can help locate potential reinforcers that can be used during intervention (Cooper et al., 2007).

Following an FBA and a preference assessment, a teacher may consider using an antecedent intervention to manage problem behavior. Because antecedent interventions offer a preventative approach, teachers and practitioners may find these interventions as a positive and useful alternative to punishment-based interventions, such as a time-out or taking away student privileges, to manage challenging behavior. In the following sections, three antecedent interventions teachers can use to manage challenging behaviors in their classrooms are presented. These interventions include presession attention, HPRS, and FCT. Table 1 shows the interventions in relation to students who may benefit from these interventions.

During independent work time in Mr. Smalley’s classroom, Pete often gets out of his seat, approaches Mr. Smalley, and begins to ask him questions that are not related to the current assignment. Pete asks lots of questions, like “Did you watch the Panthers game last night?” or “What’s your favorite

Because antecedent interventions offer a preventative approach, teachers . . . may find these interventions as a positive and useful alternative to punishment-based interventions, such as a time-out or taking away student privileges.

intervention is to conduct a preference assessment (Cooper et al., 2007). In other words, it is important to find out what might potentially serve as a reinforcer for the behavior identified to be increased (desired behavior) or replaced (undesired). A preference assessment can be done in a variety of ways, such as asking the student or others about the student’s likes and dislikes, observing the student during free time or leisure activity, or providing

Star Wars movie?” Mr. Smalley politely answers Pete’s questions and then reminds him to get back to his work, but Pete keeps getting out of his seat and keeps talking. Presession attention could be effective for students like Pete.

Presession Attention

For some students, getting out of their seat, talking during a lesson, or exhibiting other disruptive behaviors

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produces teacher or peer attention. Many teachers unintentionally reinforce students’ disruptive behavior by giving them attention immediately after the behavior occurs. In these cases, the student is more likely to use the disruptive behavior again to access teacher or peer attention. Presession attention is an antecedent intervention in which teachers give their students attention prior to a lesson or classroom activity before disruptive behavior (Roantree & Kennedy, 2006). Presession attention can have an abolishing operation effect on problem behavior (Cooper et al., 2007). In other words, by having students experience the reinforcing event earlier (i.e., as an antecedent), students’ motivation to obtain the reinforcer and the value of the reinforcer are diminished. For example, students who are frequently out of their seat in an attempt to talk to a teacher may be less likely to do so if they had a few minutes of teacher attention prior to the lesson (e.g., talking about a football game before class starts). Research has shown providing presession attention has a positive impact on reducing the frequency of disruptive behaviors (McComas, Thompson, & Johnson, 2003; O’Reilly et al., 2007). Specifically, teachers can follow a four-step process to use presession attention in the classroom: (1) determine if attention is maintaining behavior, (2) determine students’ interest, (3) implement the intervention, and (4) monitor and adjust the intervention.

Step 1: Determine if Attention Is Maintaining the Challenging Behavior

Direct observations using ABC recording as part of an FBA (see

O’Neill et al., 1997) can reveal a student’s pattern of behavior maintained by teacher or peer attention (e.g., student frequently makes inappropriate comments and peers laugh). However, if the function of the student’s behavior is to escape or avoid a difficult or undesirable task (e.g., independent math work), then presession attention would not be an appropriate intervention.

Step 2: Determine the Student’s Interests

The next step requires the teacher to understand the student’s interests and hobbies. This can be done by observing students, asking friends and family members, or directly asking students what they like to do outside of school. Interest inventories are available for students to rank certain activities on a scale of 1 to 5 and can often be incorporated in a classroom lesson. Teachers may discover that students are interested in a variety of topics that range from sports, movies, video games, computers, music, animals, or even an interesting hobby, such as woodworking, collecting items, or bird-watching. Teachers are often surprised at how effective just asking students about their interests can be.

Step 3: Start the Intervention

Step 3 is to implement the intervention with a student or students who may benefit from presession attention. Once the interest inventory is complete, the teacher can (a) find a quiet area in or outside the classroom to engage the student, (b) have the student choose a topic to talk about, and (c) start with 2 minutes of discussion about the student’s topic of choice and let the

student do most of the talking, but ask questions or share opinions on the topic (e.g., “I can’t believe the Panthers lost the game last night! Do you think they’ll be better next week?”). After the designated time (using a personal timer or letting the student keep track of the time), the student should be directed to join the class and begin the planned activity or lesson. If it is not possible to engage only one student at a time, teachers can use cooperative learning strategies (e.g., think-pair-share, numbered heads together) and give students a few minutes to discuss a preferred topic before they begin the lesson.

Step 4: Monitor Behavior and Adjust the Intervention as Needed

The final step is to monitor student behavior and adjust the amount of presession attention as necessary. For this step, it is important to keep track of the frequency or duration of the challenging behavior. Using a simple procedure for monitoring the student’s behavior, such as moving paper clips from the left pocket to the right pocket, using tally marks, or setting a phone’s digital timer, can facilitate data collection. If the student’s behavior continues to improve during classroom activities, the number of presession discussions can be reduced. In Table 2, a summary of the steps involved in using presession attention is provided.

Mr. Smalley and Ms. Marbury are concerned that Shawn, their student with autism spectrum disorder, often refuses to follow directions. The behavior specialist, Ms. Sears, has an idea: “Let’s try high-probability request sequences.”

Table 1. Antecedent Interventions to Reduce Challenging Behavior

Antecedent intervention Which students might benefit?

Presession attention Students who have problem behavior maintained by teacher or peer attention

High-probability request sequences Students who have difficulty following directions or who are noncompliant

Functional communication training Students with limited or no vocal language who engage in problem behavior to get what they want or get out of what they don’t want

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Table 2. Steps for Using Presession Attention

Intervention step Action 1 Action 2 Action 3

Step 1: Determine Observe students for Use an FBA to find out if If the student uses the if attention is disruptive behaviors (such behavior is to get adult or peer behavior to get attention, then maintaining the as talking out, getting out of attention or if it is to get out of your student may benefit from challenging behavior seat, or distracting others) an activity presession attention

Step 2: Determine the Ask students what they like Ask students’ friends or family Have students complete an student’s interests (sports, movies, computers,

or any other hobbies they enjoy)

about the things they enjoy or observe the students’ interests

interest inventory ranking certain activities on a scale of 1 to 5

Step 3: Start the Find a quiet spot free from Engage the students in a After 2 minutes, tell the intervention distraction to provide

attention with one or more students before a classroom activity

conversation topic of their choosing for 2 minutes as long as it is appropriate for the setting

student(s) you enjoyed their company and have them join the class for the activity

Step 4: Monitor behavior and adjust the intervention as needed

Observe student behavior and track if disruptions increase or decrease

Alter the intervention if necessary by increasing the amount of time talking with the student or by reengaging the student during the activity

You can also allow students time to talk with one another (e.g., think-pair-share) before beginning a classroom activity

Note. FBA = functional behavior assessment

HPRS

HPRS have been found to be one of the most thoroughly researched antecedent strategies used to increase compliance (Radley & Dart, 2016). HPRS involve providing students with a series of three or four easy-to-perform requests, providing reinforcement for compliance with each of these requests, and then immediately instructing students to engage in the targeted, low-probability request (Mace et al., 1988). The HPRS procedure increases the rate of reinforcement provided to a student for compliance, which establishes a “momentum” of compliant behavior. This momentum continues when asked to perform the more challenging or

less-preferred task. The HPRS procedure has been successful in increasing compliant behavior related to general requests (Esch & Fryling, 2013), transitions between activities (Singer, Singer, & Horner, 1987), and social-related requests (Jung, Sainato, & Davis, 2008). Researchers have focused on variations of HPRS to determine the most efficient way of implementing this nonaversive procedure while producing the most effective results (Houlihan, Jacobson, & Brandon, 1994). Although variations of the HPRS procedure are common in the literature, most researchers agree on a set of characteristics or steps that are necessary for increasing the intervention’s effectiveness (Lipschultz

& Wilder, 2017). These recommendations are listed in Figure 1 and discussed in the following section.

Step 1: Identify the Targeted Low-Probability Request

The first step involves identifying the targeted low-probability request (e.g., asking the student to turn off the computer game). When selecting the targeted noncompliant behavior, it is important to ensure the student has the skills necessary to both understand and perform the request given (Majdalany, Wilder, Allgood, & Sturkie, 2017). Researchers have typically identified low- probability requests by interviewing adults familiar with the student (e.g., teachers, parents) and then conducting

Figure 1. Steps for using the high-probability request sequences procedure.

Using High-Probability Request Sequences

1. 2. 3.

4.

Identify the targeted low-probability request(s). Identify three to five easy-to-follow requests (i.e., high-probability requests). Use high-quality reinforcers to reinforce the student’s compliance with both high-probability and low-probability requests. Deliver all requests in rapid succession (i.e., 2-5 seconds between the delivery of reinforcement and the proceeding request).

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Table 3. Example High-Probability Request Sequence

Action in sequence Example

Gain the student’s attention Make eye contact and state the student’s name.

Provide first high-probability request “Give me a high five, please.”

Immediately provide reinforcement “Thank you for that high five.”

Provide second high-probability request “Stand up, please.”

Immediately provide reinforcement “Great job standing up.”

Provide third high-probability request “Push in your chair, please.”

Immediately provide reinforcement “Fantastic, thank you for pushing in your chair.”

Provide low-probability request “Okay, it’s time for lunch. Let’s go to the sink so we can wash our hands.”

Immediately provide reinforcement for compliance with low-probability request

“I love the way you walked over to the sink to wash your hands. We will add a sticker to your chart.”

presession observations to determine the percentage of compliance that occurs with each targeted request (Ducharme & Worling, 1994). A common inclusion criterion for considering a request as having low probability has been when compliance occurs less than 40% of the time (Ducharme & Worling, 1994). Consideration should be made in selecting approximations of more complex tasks that involve multiple steps. For example, if students refuse to wash their hands when requested, it may be necessary to target the first step in the procedure (e.g., going to the sink), instead of asking students to complete all steps involved in hand washing.

Step 2: Identify Three to Five Easy-to-Follow Requests

Once a low-probability request has been selected, similar procedures (i.e., asking familiar adults, directly observing the student) should be followed to identify the targeted high- probability requests. Typically, 80% and higher compliance has been the criterion for researchers to consider a request as having high probability (Axelrod & Zank, 2012).

Step 3: Use High-Quality Reinforcers

In addition to identifying both types of requests, it is important to identify high-quality reinforcers to reinforce

compliance (Wilder, Majdalany, Sturkie, & Smeltz, 2015). Much of the early research on HPRS provided descriptions of the reinforcement given (e.g., verbal praise) but did not provide a systematic method for determining what stimuli should serve as reinforcers (e.g., Mace et al., 1988). More recent research has suggested that teachers should use stimulus preference assessments as a means of identifying possible reinforcers (Wilder et al., 2015). Reinforcers should be selected that can be delivered relatively quickly (e.g., praise) in order to maintain the momentum of reinforcement for compliance throughout the procedure. In addition, reinforcers should be delivered contingent on and immediately after compliance with each request (Lipschultz & Wilder, 2017).

Step 4: Deliver the Requests in Rapid Succession

After appropriate requests and reinforcers have been identified, the HPRS procedure is ready for use. The teacher should first get the student’s attention (e.g., make eye contact and state the student’s name) and then provide the first high-probability request. Immediately following compliance (2–5 seconds) with the first request, reinforcement should be provided. This sequence is repeated for the next two

high-probability requests. Immediately after reinforcement is given for compliance with the last high-probability request in the sequence, the teacher should give the low-probability request to the student. Reinforcement is given immediately after compliance with the low-probability request. An example is provided in Table 3.

Mr. Smalley and Ms. Marbury have Kenisay, a third grader who is nonvocal and has an intellectual disability, included several times a day in their classroom. Kenisay kicks her feet and bangs her hands when asked to participate in class projects. “She’s fine when she’s alone and playing with her iPad, but we can’t seem to keep her engaged in class activities for more than a few minutes,” says Ms. Marbury. For students like Kenisay, who have difficulty communicating their wants and needs, FCT can be used to prevent problem behavior and teach an appropriate way to communicate.

FCT

Research has shown a strong relation between the lack of communication skills and the presence of challenging behaviors. In other words, students who do not have a functional communication system (e.g., speech, manual sign) are more likely to engage in challenging

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behaviors, such as aggression, self- injury, or property destruction, as a means of communicating their wants and needs (Chiang, 2008). These students who engage in challenging behaviors may benefit from FCT (Carr & Durand, 1985). FCT is a behavioral intervention that has two purposes: (1) assessing the communicative function(s) of the student’s challenging behavior(s) and (2) teaching the student an appropriate communicative response that results in accessing the same reinforcer that is maintaining the challenging behavior (Carr & Durand, 1985). FCT is an evidence-based practice that has been effectively used to teach appropriate communicative responses as a replacement for the challenging behaviors of students with intellectual or developmental disabilities (Andzik, Cannella-Malone, & Sigafoos, 2016) and autism spectrum disorder (Wong et al., 2013). FCT can be used with students as young as 3 years old who have deficits in communication skills and engage in challenging behaviors (Simacek, Dimian, & McComas, 2017).

Step 1: Identify the Function of Challenging Behavior

A key component of FCT is determining the function of the student’s challenging behavior (i.e., What is the student trying to communicate through the challenging behaviors?). As aforementioned, an FBA can be used to determine the function of challenging behaviors, such as gaining attention, access to tangibles, or escape from demands. After conducting an FBA, teachers should analyze the data to determine the function(s) of the student’s challenging behaviors. For example, direct observation may reveal that a student bites or hits to gain attention. Analyzing FBA data should lead to a hypothesis of why the student is engaging in challenging behaviors.

Step 2: Choose a New Communicative Response

After determining the function of the student’s challenging behavior, teachers select a new communicative response for the student. The new

communicative response has to meet a few criteria in order for a successful implementation of FCT. The response must (a) be easy for the student to learn, (b) result in the same consequences (e.g., attention, a break from a task) as quickly as the challenging behavior, and (c) be easily noticed by teachers, peers, and caregivers (Dunlap & Duda, 2004). The new communicative response could be an unaided system, such as manual signs and spoken words, or an aided system, such as the Picture Exchange Communication System (Frost & Bondy, 2002) and speech-generating devices, such as iPads.

Step 3: Teach the New Communicative Response

After choosing the communicative response, the next step is to teach the student to use the communicative response that serves the same function (e.g., getting tangibles) as the challenging behavior. For example, if the student pinches the teacher to escape from a task, present the task to

Table 4. Steps for Using Functional Communication Training

Intervention step Action 1 Action 2 Action 3

Step 1: Identify the function of challenging behavior

Conduct FBA (i.e., interviews, direct observations, or functional analyses)

Analyze the data collected in FBA

Develop a hypothesis of the function(s) of the challenging behaviors (e.g., attention, escape from demands, tangibles)

Step 2: Choose a new Select a new response that Consider using an unaided communicative response can be easy to learn, leads to

the same reinforcement as the challenging behaviors, and is easy for others to understand

system (e.g., sign language) or aided system (e.g., PECS or speech-generating devices)

Step 3: Teach the new Teach the student to use the Immediately provide Gradually increase the communicative response new communicative response,

using prompts (gestures, hand over hand) to help the student learn the new response

reinforcement (i.e., what the student wants) after the student uses the new response

criterion before the student can receive reinforcement

Step 4: Reduce Withhold reinforcement (i.e., Ensure that everyone (e.g., challenging behaviors as much as possible) when the

student engages in challenging behaviors

caregivers, teaching assistant) is withholding reinforcement when challenging behaviors occur

Note. FBA = functional behavior assessment; PECS = Picture Exchange Communication System.

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