Brief Description of PBS Related to Emotional and Behavioral Disorders
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Children with emotional and behavioral disorders (EBD) who do not receive appropriate support are at risk for many negative outcomes including serious mental health problems, substance abuse, and school failure. Longitudinal research suggests that these children become adults who experience lifelong difficulties related to substance abuse, marital discord, employment problems, arrests and institutionalization for crimes or mental health disorders. Research also indicates that children with emotional and behavioral disorders are at greater risk for involvement within the juvenile justice system. One of the challenges encountered in supporting a child with emotional and behavioral disorders is created by the lack of effective coordination across the agencies providing assistance to the child and family. Differences in mission, purpose, training, and professional viewpoints can make communication challenging contributing to a breakdown in effective support for children with EBD.
Positive behavior support is a set of team-based processes that can assist in the support of children with EBD. The first step in the PBS process for a child is wraparound planning. Wraparound is a philosophy of care and a team-based planning process that blends the support of multiple service agencies in order to create a positive set of outcomes for children and families. A core feature of the wraparound process is the emphasis placed on including families as full and active partners in the decision making process. Many families who have children with emotional and behavioral disorders must communicate across many different types of service systems. The communication and advocacy needed is daunting, especially when families are faced with economic hardships, and/or physical or mental health related issues that make it difficult to advocate effectively for their children.
The team supporting a child with emotional and behavioral disorders will create a positive behavior support plan with the child that is intended to make problem behavior irrelevant, inefficient, and ineffective. The process for identifying why a child is engaging in problem behavior is called Functional Behavioral Assessment.
Functional Behavioral Assessment (FBA)
The functional behavioral assessment (FBA) process involves gathering information about what is maintaining a child’s problem behavior. A variety of assessment tools are used to conduct a FBA. Interviews with teachers, parents, the child, and other important individuals are usually a first step for gathering information. Observing the child in his natural environment provides further evidence regarding the function of a problem behavior. The team working with the child systematically observes him/her in different settings to see if there are certain environmental variables triggering problem behavior. A functional behavioral assessment is considered complete when the following outcomes are accomplished:
- there is a clear description of the problem behavior,
- the events, times, and situations that predict both the occurrence and nonoccurrence of problem behavior are identified,
- events immediately following problem behaviors are identified,
- one or more educated guesses (hypotheses) about the function maintaining problem behavior are developed, and
- direct observation data identifying and confirming the function of the problem behavior is complete.
Individualized Multi-component Interventions
The team that forms to support a child or adult in order to create a PBS plan should include the people who are actively present in the situations and settings that are part of the child’s life. Information gathered from a functional behavioral assessment helps this team develop and implement behavior support plans that are positive, proactive, educative, and functional. PBS plans include a number of interventions that can be implemented across situations and settings. These interventions include: 1) proactive strategies for changing the environment so triggering events are removed, 2) teaching new skills that replace problem behaviors, 3) eliminating or minimizing natural reinforcement for problem behavior, and 4) maximizing clear reinforcement for appropriate behavior. A hallmark of PBS planning is emphasis on improving overall lifestyle quality (relationships, activities, health) as an integrated part of behavior support.
PBS focuses not only on reducing behavior problems, but on enhancing a person’s overall quality of life. Outcomes include lifestyle improvements such as participation in community life, gaining and maintaining satisfying relationships, expressing personal preferences and making choices, and developing personal competencies. Such improvements in quality of life are facilitated by establishing a positive long-range vision with the individual and his/her family (e.g., through wraparound planning) and establishing natural supports through effective teamwork.