Many of us are familiar with school-wide positive behavioral programs that focus on values such as respect, kindness, and hard work and reward students when their behavior reflects those values. But how do these programs include children with disabilities, particularly those with extensive behavior and/or support needs in general education environments? When can school-wide interventions be modified?
Education advocate Dr. Sarah Pelangka explains that it’s based on the needs of the child. “Behavior supports come in many forms,” she says, “such as behavior strategies (e.g. embedding visual supports, checklists, token systems self-monitoring checklists, organization systems, etc), incorporating home-school communication logs to align home and school, adding in behavior goals, adding in a behavior plan, adding in behavior intervention services (this takes the form of the school behavior team consulting and collaborating with the student’s team), completing a Functional Behavior Assessment (FBA), adding in a behavior aide with behavior supervision from the school BCBA, etc.”
Dr. Caitlin Solone, education advocate and academic administrator for the Disability Studies program at UCLA, discusses the importance of behavior support for children with disabilities seeking inclusion in school and stresses that a child's behaviors are a means for communication.
A Positive Behavioral Interventions and Supports (PBIS) program is often used in schools to help encourage good student behavior. In a school setting, PBIS is an evidence-based practice for reinforcing students' good behavior. PBIS is not a one-size-fits-all system but an approach that helps reduce problematic behavior and build relationships between students and teachers. PBIS involves establishing expectations for students, teaching students what those expectations are, and rewarding them when they meet those expectations to build a positive reinforcement system. Because students benefit from consistency, PBIS is implemented throughout an entire school rather than in only one classroom.
Dr. Sally Burton-Hoyle, professor, ASD Area, and faculty advisor in the Department of Special Education College Supports Program at Eastern Michigan University, tells us that when she’s in special education classrooms and a child has displayed a behavior such as getting angry and knocking all the books off a shelf, she’ll ask the teacher if the child knew what the expectation was of them, and how. Typically, a teacher will express expectations verbally, but often, other methods can be more effective, such as having visual representations or Social Stories.
“I'm going to guess that 90% of the time, when children are acting up, [expectations weren’t] made clear to them,” Dr. Burton-Hoyle says. “A part of positive behavioral support is making sure that people have the expected outcomes ahead of time, and that it isn't a surprise to them. And I don't understand people who put kids with disabilities in this kind of situation… When you instruct kids and they don't understand what they're supposed to do, they're going to do something challenging.”
You can also think about using the Positive Behavior Interventions and Supports strategies at home and making a PBIS home plan. “When you teach your child the same behaviors that are taught at school and reinforce them at home, you are encouraging your child’s social and academic growth,” the PACER center explains. Learn more about this here.
One of the primary ways to address your child’s behaviors is through an assessment. According to Rose Griffin, speech language pathologist, Board Certified Behavior Analyst, and founder of ABA Speech, “Whatever avenue you're going, so if you're doing Floortime, you're doing ABA, you're doing speech therapy — I think what's most important is that we start with an assessment so we can kind of see where is the student? And then where are the strengths? Where are the areas that we need to support our students? What does that support look like? And just making sure that providers are going to be really detailed with that plan, and how that plan is going along the way. You don't want to just set the plan and forget the plan and think that everything is going to happen, right? Because it's not that easy. So I think just having that general framework, and if you're working with a provider that doesn't do those things, then that might be another red flag as well.”
A Functional Behavior Assessment (FBA), which is often (but not always) conducted by a BCBA, is an assessment that you discuss with your IEP team. Note that in the state of California, a BCBA is not a legal requirement for FBA completion; an FBA can be completed by a school psychologist and even a SPED teacher. An FBA looks at what’s leading to and following a behavior in order to develop a behavioral intervention plan (BIP), which then gets included in the IEP.
Dr. Pelangka explains, “Within the educational setting, a behavior intervention plan (BIP) is a written plan designed to support school staff in knowing how to set up the student's environment to allow for success and independence, communicate strategies to help proactively prevent behaviors form occurring, and communicate reactive strategies so all staff are consistent in how behaviors are responded to.” It also includes behavioral goals and evidence-based strategies to help the child achieve those goals. FBAs can be conducted when the IEP team determines it would be appropriate for the child, or when a change in placement is being sought due to behaviors. Once an FBA is requested, the district has fifteen days to provide you with an assessment plan. Once that is signed and returned, the district then has sixty days to conduct the FBA and hold an IEP meeting to discuss it.
Dr. Pelangka tells us, “An FBA is an assessment that essentially looks at the student’s immediate environment via direct observation. Through the FBA, the assessor hypothesizes what may be contributing to any problem behaviors the student may have. The FBA should also incorporate interview data, adaptive skills assessment (to rule out skill deficits), and a comprehensive records review, to again rule out skill deficits.” She adds that, “It’s not true that only ‘dangerous’ behaviors warrant an FBA (as is often communicated to parents). Behaviors that are occurring at high rates or for long durations that impede the student’s ability to learn can warrant an FBA.”
Dr. Burton-Hoyle explains how FBAs can help get to the “why” of a problem, and how parents can advocate for the school to do more thorough FBAs of their child:
What happens after an FBA? Dr. Pelangka explains that the outcome of an FBA may include recommendations, such as:
Low-level BIPs don’t require an FBA, she tells us, and can be written by the IEP team collaboratively. The team would go through the BIP section by section and develop a plan that they believe will best meet the needs of the student. Ideally, there would be data to work off of to create the BIP, but if not, the team can suggest going back to collect data, or they can agree that there is a need and data will be collected moving forward. Any Tier 3 or Comprehensive Behavior Plan does require an FBA, however.
Dr. Pelangka adds that parents should be aware that the FBA assessors do not deem skill deficits to be maladaptive in nature (maladaptive behaviors are those that the student can control). For example, a student might have a learning disability in the area of orthographic processing, which directly impacts writing. “If the maladaptive behavior found is that a student engages in work refusal during writing tasks,” she says, “we shouldn’t be writing a behavior goal for the student to ‘complete writing tasks’ or ‘ask for a break during writing tasks.’ We should be focusing on what tools the student has to access writing, given they have a learning disability in the area of writing (e.g., assistive technology tools, access to a scribe, etc.).”
IEP goals are one of the most important parts of a student’s IEP, and this includes behavioral goals. IEP goals should be appropriately challenging and aligned with a student’s strengths, needs, and interests. This report from the Autistic Self Advocacy Network (ASAN) explains that behavioral goals should ideally involve the child and the child’s desires, preferences, and voice, but if they can’t communicate due to age or other developmental or physical barriers, goals should be created by the IEP team in a way that best allows the child to lead a self-determined life.
”If a goal must be set against a person’s wishes (e.g., teaching someone not to run into traffic so they can safely cross the street), it must be explained to them why it is so important and implemented in such a way that the person maintains as much control over the intervention as possible,” says ASAN. Behavior goals should also be strength-based and incorporate a child’s interests, “not as a way to modify their behavior, but to engage with that person and increase the chances they will find the intervention meaningful.”
As an IEP team, finding out what the child is motivated by can help with interventions and goals that fit with the child’s unique strengths. For example, if a child is interested in unicorns, building unicorns into the intervention can increase the child’s own motivation to meet their goals.
As Dr. Burton-Hoyle tells us, IEP goals should not be about reducing “unwanted” or “bad” behaviors because an IEP is based on the child’s needs and the goals are then based on those needs, not on reducing behaviors, but perhaps replacing them with more functional behaviors. “We begin with needs and proceed to write goals that will meet the needs. The accommodations address how the goals can be met and what they need for this goal to happen. Services and supports support the individualized goals for the child. The least restrictive environment and school placement should be the most appropriate location for needs and goals to be met.”
When it comes to goals and BIPs, Dr. Pelangka explains, “A BIP provides FERBs (functional equivalent replacement behaviors). FERBs are goals that service the same function as the target/challenging behavior, which is very important for parents to be aware of. Schools cannot write goals that are the desirable response (e.g., instead of eloping, Bobby will remain in his seat and do his work). Rather, schools are required to write goals that serve the same function as the behavior the student is currently engaging in (e.g., Bobby will request help when provided with an assignment he perceives to be difficult, as evidenced by Bobby's sighing and putting his head down).”
Dr. Burton-Hoyle adds that sometimes schools may skip important steps and start with placement, such as automatically assuming a child will go to a segregated school due to their behavior, but that's not that's not how the IEP is supposed to go. “Let's talk about their needs. And it cannot be something that the child shouldn't be doing,” she says. For example, “Instead of [focusing on reducing the] banging the head, what should that child be doing? Maybe playing with other kids? That's the positive behavioral support [approach]. Then banging his head: what does it mean? That means he's frustrated or it means he's lonely. Then the goal is around that, not reducing something.”
Dr. Scott Akins, chief of developmental behavioral pediatrics UC Davis, Department of Pediatrics and medical director at the UC Davis MIND Institute, shares that when it comes to goals, he often focuses on effort and impact. If something is low effort and high impact, it can be a priority right away. If it's high effort and high impact, you can talk strategically with your provider or therapist and plan to focus on it at a specific time. For example, trying toilet training during winter break so that parents have more time to dedicate to putting the child on the toilet multiple times a day, every two hours.
“It's super impactful if we can get it accomplished. So first, I start with that and help families think about capacity. And then the other thing we think about is just the degree of impairment. So I don't mean this in the opposite of strengths-based, I just mean for family function and for the child — what are the toughest things right now? Let's talk through them then try to set priorities around that. Then the strengths-based piece comes in because each of these interventions need to be developmentally appropriate.”
For example, he continues with toilet training: “If a family member said to me, ‘I just need him toilet trained, I can't take it anymore and he can't get into a certain school if we don't do it.’ But then I sit down and we talk it through, and the child can't hold their urine for a few seconds, doesn't get upset when they're wet, and can't pull their own clothes up and down yet; we're probably not ready. Those core readiness skills aren't there. So it wouldn’t be developmentally inappropriate for me to spend 24 hours a day doing that for two weeks and would lead to more frustration for the family. And it would feel like a failure.”
Dr. Akins wants parents to think about aligning what's developmentally appropriate with the child’s strengths and biggest challenges, then “trying to chip away with the things that are most impairing family function [because] it's just so hard not to be frustrated as a caregiver at times, and not to be overwhelmed. But when we start to have successes and some of those things that are most frustrating for us get better, it just frees up all this mental space to then maybe take on something a little harder but more high impact.”
When schools write IEPs, goals around behavior may be compliance-based, such as reducing a certain behavior that is deemed challenging or problematic. For many kids with developmental disabilities, IEP goals can actually promote masking their traits and behaviors in an attempt to “normalize” or “reduce” their behavior, which may be inherent to who the are, how they process sensory stimuli, and how they communicate (for example, goals for more eye contact, tone policing for appropriate responses, constantly initiating conversations, etc.). Certain goals can set up children for manipulation, exploitation, and bullying. Many of these goals have the word “appropriate” in them — as in “appropriately respond” or “appropriately acknowledge” — and may be expected even when a child is being teased or bullied.
While most parents would agree that working on reducing behaviors that may be harmful or dangerous is important, goals need to focus on more than just reducing a behavior, and they may not even be about the specific behavior.
IEP goals that center the unsolved problems can work toward supporting a child in building skills and interests that allow them to grow beyond the behaviors.
An article by Autism Spectrum News tackles how, in addition to listening to our children’s needs and desires when creating IEP goals, “we need to write better, more nuanced, and collaborative goals with respect with self-advocacy skills at the forefront.” For example, replacing references to “non-compliance” in IEP goals with skills to focus on in therapy instead. Creating strengths-based goals instead of decreasing non-compliance can look like increasing skills such as communication, negotiation, compromise, “no” responses, and problem-solving.
Neurodiversity-affirming goals often start with a neurodiversity-affirming assessment. Breea Rosas, school psychologist and founder of Neurodiversity Affirming School Psychologist, tells us, “The difference between a traditional, school based evaluation and a neurodiversity-affirming evaluation for an IEP is really the lens that it's taking. So rather than saying that a child has ‘deficits’ in areas, you might see things like ‘differences’ in certain areas. You'll see things that really highlight how the student works and learns best, how the student stays regulated. Rather than focusing what we traditionally focus on — the behaviors that we're seeing or when students aren't doing well — neurodiversity-affirming assessments and IEPs are going to highlight the things that the child can do well and the things that support the child when they need that extra additional support to do well.”
Other examples she gives us is that instead of language such as, “The child constantly argues with adults,” you might see, “The child has unique self-advocacy skills, and is self-aware enough to know their likes and dislikes.” Or, instead of, "Child has deficits in social emotional reciprocity,” you might see, "The child has differences in how they communicate and their social interactions might look different than someone who's neurotypical." Or, instead of, "The child elopes six times per day,” you might say, "The child is able to meet their sensory needs by taking a break from the classroom six times a day." She explains, “Those slight reframes are really important and they tell us maybe this kid needs a break from the classroom six times a day, let's make sure that we can do that in a way that's still safe for them and meets their needs. Or, ‘Hmm, this kid is taking a break from the classroom six times a day, we need to do something to make that classroom more acceptable for them, more suitable for them.’ So I'm reframing it in a way that doesn't put it as a negative thing that the kid is doing… Those changes in wording really helps shift the lens of everyone interacting with them.”
Learn more about neurodiversity-affirming assessments in our conversation with Rosas here!
How can IEP goals around behavior be more neurodiversity-affirming, instead of trying to make a child "comply?" Dr. Pelangka tells us, “One of the biggest issues I see in school-based BIPs is deeming maladaptive behavior as a symptom of their disability. For example, a student has ADHD and the target behavior is ‘off task.’ But that is to be expected. Why would we write a plan with an expectation for the student to magically be on task? Even if the plan is written in such a way that they earn something rewarding for being on task, how do you think that student feels when they don’t meet their goal because they can’t as a direct result of their disability? That feels awful. BIPs should be written to support behaviors that are not a direct symptom of their disability. For [self-soothing behaviors] SSB, we can’t say, ‘Stop stimming,’ but IEP goals can be written to support skill deficits or giving the student strategies to help them increase more awareness to be on task more. If the student with ADHD is throwing things across the room, that can be addressed in the BIP, but not being off task.”
Similarly, Dr. David Stein, PsyD, pediatric psychologist, explains that compliance-based and “on task” behavior goals don’t always work.
Rosas explains that neurodiversity-affirming goals focus on things like regulation, self-advocacy, and what the child wants. Because of this, “The goals are going to be better and the accommodations are going to be better because when you're a neurodiversity affirming provider, you're going into the classroom and you're looking at what things are supporting this child right now, and what things are not working. So you can make a really solid IEP because you're not just looking at [a kid] moving around a lot, you're looking at, ‘Huh, this kid likes to stand while they're working, that's an accommodation we're going to put in their IEP. They are fiddling with things on their desk, let's get them some fidget tools — that's a great accommodation for their IEP.’”
Dr. Pelangka shares that goals, whether clinic-based, home-based, or in the IEP, shouldn’t be aimed at trying to change the person but to support them in what they actually desire for themselves. For example, it’s not necessary to establish goals for more eye contact. It can be overstimulating for their brains, it depends on the culture, and individuals can show that they are engaged in other ways (e.g., remaining in the area, facing the direction of a communicative partner, responding with related responses, etc.). “We should aim to give them the tools to have meaningful and positive social experiences,” she says.
Dr. Pelangka tells us, “Given the influx of self-advocates who have come out and shared their stories on ABA (and how detrimental it’s been to them), I firmly believe it is imperative that we, as behaviorists, do a better job. The goal should not be aiming for “compliance,” but rather, the goal should be aiming for acceptance. What I mean by that is the students' acceptance of the adult (teacher), the classroom, and the content being taught.” What does this look like? She gives us three examples:
Building and establishing rapport and trust with the student (acceptance of the teacher/adult).
Ensuring the classroom is a safe space for the student. This can be accomplished by embedding things that support the student (e.g. dim lighting, headphones, fidgets, preferred visuals on walls, etc.) and being willing to modify the room on an ongoing basis to meet the needs of the student (for example, if the classroom gets too loud).
Teaching to their level and ensuring access by way of accommodations and services. The student should have all of the services and supports they need to be most successful. “This sounds like a ‘duh,’” she says, “but I can’t tell you how many parents I come across who don’t even know they can ask for an assistive technology assessment for access to curriculum, not for AAC purposes. Or counseling, or recreation and leisure, etc. There are so many things accessible to students; they should be offered when needed.”
Another thing to consider is that students with disabilities can often face harsh and exclusionary disciplinary action at school around behavior. The Individuals With Disabilities Education Act (IDEA) requires school teams to use positive behavior interventions when supporting students who receive special education services with their behavior and social and emotional development. Dr. Pelangka recommends that parents hold the school accountable by discussing behavioral interventions during their IEP meetings.
What else can you do to protect your child? What does all of the above information mean for you and your child?
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