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Selecting an Intervention Method

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Participant and Setting
Noah is a friendly, eager to please 16-year-old 9th grader who enjoys travel and books. He is presently performing at grade level for the Occupational Course of Study program and has problems with managing behaviors related to anxiety, including blurting out, interrupting, seeking negative attention from peers, and talking back when redirected. The psychological evaluation lists ten diagnoses that have been formally assigned to Noah, including Fetal Alcohol syndrome, Separation Anxiety, and Oppositional Defiant Disorder. His updated psychological evaluation limited target diagnoses to ADHD, Anxiety, and Autism. Besides, suggestions on the subjective assessment were targeted for impulsivity, hyperactivity, and defiance. He is currently not taking any medications. His parents have been considering putting him on medication for the hyperactivity. He has been provided with a one on one Autism specialist, who works with him after school through the evening. His parents are also considering hiring a one on one support staff for the day since Noah receives most of his stimulus at school, which is when the behaviors show the most. His parents are requesting that the teachers have additional meetings with support staff that works outside of the school system.
Noah struggles with impulsivity throughout the school day, especially when around peers and larger groups of people. He will blurt out over direct instruction, talk over peers when they are permitted to speak, interrupt conversations and social activities of peers, and do actions that are considered the offense to peers with the reason that he thinks it is funny.

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When Noah is directed to stop his behaviors, move from stimulation (putting head down), marking a blurt chart on his desk, or asked to move to another task or setting, he often refuses. When reminded of rules, he sometimes escalates to making threats towards the teacher.
Noah was put into foster care and has lived in multiple homes before his adoption in 2010. His new parents report that it has been a challenge with integrating him into the house. Noah has been homeschooled for the past four years, then placed in a public school of about 2,000 students. He was removed due to bullying by peers. He was placed at a specialized school for children with behavioral difficulties. The classrooms have a small set of 12-14 students, with a teacher and an assistant. The assistant is not always present in the school, due to other required duties.
The school is designed for teaching students to manage their emotions, social skills, and life skills so that they can function in the real world and support themselves. Besides, they are taught to work in a group, function in a classroom, and take the perspectives of other people. Noah started the school year strong and had been confident and eager to please. However, he has been resistant to instruction and feedback on social skills and appropriate classroom behaviors. He will show off-task behaviors when instructed in social skills, and talk back when corrected by the teacher for undesired behaviors. His peers have begun to tell him to stop, and/or show signs of frustration with his actions. When asked if he notices his peers, or what he thinks about his peers’ reactions, Noah will laugh or say he does not care.
Behavioral Definitions
The target behavior is impulsive behavior, defined as incompatible to social skills instruction and classroom settings, including blurting out, interrupting and talking back when redirected.
The replacement behavior is to wait, think, respond as necessary, defined as listening to peers and teachers before making a response and when invited to make an answer, and listening when redirected.
Interviews and A-B-C data
Interviews were conducted with two of Noah’s teachers, assistant principal, and teaching assistant. A-B-C data were collected in his English class.
Staff Interview
Noah’s teachers, assistant principal, and teaching assistant met to discuss his behavior. All teachers felt that he was appropriately placed in his education classes and that he was able to provide work that met requirements when he was showing on task behaviors. He has shown an eagerness to learn and is willing to do a job to please the teacher. When there are sounds in the classroom, such as the teacher giving instructions or a student saying an answer after raising their hand and being called on, Noah will start responding with comments and often will continue commenting after redirection from the teacher, requests from peers to stop, and then warnings from the teacher of consequences. Often, Noah will keep making comments and will try to engage peers, until he has the last comment. The behaviors cause an interruption in the class and distract himself and peers from learning.
All teachers and staff agree that Noah appears to seek attention from teachers, staff, and peers. The assistant principal, who has worked with Noah for many years in another program, suggested that Noah is seeking negative attention from peers, and stated that Noah is aware of what he is doing, due to formerly being taught replacement behaviors by the assistant principal (in the other program) with success. The assistant principal has spoken with Noah on a few occasions recently when requested by teachers, with the result of Noah showing calmer, more self-controlled behavior. The staff discussed that Noah might have shown desirable behaviors in the other program, due to it being a different setting, and the school setting itself may be overwhelming to Noah. They discussed how he was homeschooled for four years, and how he had extreme bullying within days of being placed at a large high school with a lot of students (2000+) and a lot of transitions (changing classrooms independently).
The teaching assistant felt that Noah was deliberately defiant. The assistant has attempted to use tokens as a means to reinforce the behavior. He has noticed that Noah has an attachment to a particular book from home. The assistant has used removal of the book as a means to get Noah motivated to stay on task. The assistant has also removed Noah from the classroom setting to write papers as a consequence for his behaviors. The assistant is in the classrooms for only half of each teaching day.
The Math teacher noticed that Noah performs well when giving an independent task with headphones. However, when among peers and receiving direct instruction, he will blurt out, or not show full body listening. He will pick at his hand with a pencil, even after requests to stop. During group projects or peer learning, Noah will attempt to start task conversations and cannot stop, also when peers ask him to terminate or refuse to engage. He will look around for a peer who may be looking in his direction and continue to converse. Peers are either confused or irritated. When given feedback from the teacher, Noah will ignore and keep talking, or talk back to the teacher. When warned of removal from peers, Noah will refuse, and continue to decline when asked to move. Sometimes intervention from the assistant principal is required.
The English teacher noticed similar behaviors. The English teacher, who is at recess and lunch duty, also offered information on Noah’s behaviors with peers. Noah will approach peers without invitation, interrupt their conversations or tasks, attempt to dominate, and go against their plan or goal (for a game, he may take the balls and kick them over the fence) (for a conversation, he may jump in and say something deliberately offense to the group such as a racist comment to a group of African Americans). During lunch, he will talk over peers, attempt to get peers to throw things, and recently was throwing peanuts at a student with peanut allergies. When asked why he does these actions, he says he finds it funny. When told to stop, he will laugh and talk back.
Student Interview
His answers to the interview questions stated that he does not have difficulty in working with peers and that he does not get distracted in class. He said that the expectations of the school and the classroom were manageable. When asked about his interactions with peers, Noah said he has no problems with peers. When asked about specific examples of interactions with peers, which were negative attention seeking behaviors, he said the goal of his actions were to be funny. When asked what he thought his peers thought about him, he said he did not care. The assistant principal was called to help with the interview after these conclusions were made. The principal assistant prompted Noah with examples of the benefits of peers liking him, such as getting invited to work in groups, go to parties, and go to people’s houses. Noah changed his responses to saying that he did want to make friends, and he did care what other people thought of him. The AP (assistant principal) felt that Noah knew better. The staff felt that Noah had difficulty with impulse control and was unable to stop his impulsive behaviors when in the moment of external stimulus. The interview process had not been initially successful because Noah may have been overstimulated and responded with negative seeking attention behaviors such as saying he does not care. The staff discussed and decided to help Noah by planning some specific social skills lessons that targeted the situations that he had difficulty, such as the lunchroom, recess, and classroom with peer interactions.
A-B-C data
A-B-C data were collected for four 15-minute intervals that occurred during Math and English and during lunchtime. Due to the school being designed to teach social skills and behavior management, including during lunch and recess, the staff felt that it was important to observe behaviors where social skills would be best seen. Noah’s impulsive behavior such as blurting occurred during 37 from the 53 off-task behavior recorded instances. The pattern relating to his blurting was when any inconsistent sounds were made that broke the silence in the classroom occurred. It often was when a student asked a question or when someone walked by. When instances like this happened, and he began to blurt, he was given a verbal command to stop and sometimes a command to observe his peers and follow the group plan. After the verbal command, he would get back on task for 1-5 minutes on average. If he were unresponsive or defiant, then the teacher would call for backup.
The function of the Behavior
The interview and A-B-C data indicated that Noah’s impulsive behavior enable him to receive attention from peers and staff (positive reinforcement – attention).
Function-Based Intervention
To identify the appropriate intervention, the following question was asked: Can Noah perform the replacement behavior? The answer is Yes. Noah has the prerequisite capacity to interact with his peers in classroom and instructor without hurting them. The next question was asked: Do the antecedent conditions represent the best educational practices? The answer is Yes. The verbal command to tell Noah to stop the off-project behavior and observe his peers, and taking him through instructional, social lessons targeting his difficulty situations such as the lunchroom, recess, and classroom with peer interactions are necessary for his behavior change. Based on this information, Method 3 was used to develop the following function-based intervention: Noah will conform to socially acceptable behavior among peers and groups often if instructional commands are given and directed consequentially to observe his equals.
Method: The consequences are manipulated so that the target behavior is decreased and the replacement behavior is stirred to occur.
Method Elements Resulting Intervention Elements
The consequences are manipulated so that the target behavior is decreased and the replacement behavior is stirred to occur.
(a) show the consequences of losing friends and living lonely if a don’t care attitude is consistent at his grade level.; and
(b) Provide instruction with a commanding tone where there is persistence on an impulsive behavior; and
(c) Provide peer helper; and
(d) Do not spare Noah when interrupts his peers; and
(e) Place Noah with peers who do not entertain his blurts and impulsive interruptions.
Provide appropriate reinforcement for the replacement behavior Provide positive support for socially appropriate action such as gifts when he stays on course and attentive in classroom and group projects such as a ball.
Withhold the original reinforcer when the target behavior occurs (extinction) Noah must comply with his instructors’ directive, briefly redirect him and remind him that the punishment is due for every blurting out and unacceptable behavior he exhibits
.
Since Noah can concentrate and refrain from impulsive attention-seeking behavior when he is reprimanded and observed by the teacher carefully, the instructors applied this corrective plan, and it’s helpful to him.

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