My Journey to Improving My Son's Challenging Behavior with Positive Behavior Support: Part 6 - Putting the PBS Plan in Place

Putting the Positive Behavior Support Plan in Place

It is very exciting times. We now have a plan of action for preventing, solving, replacing, and managing Richie’s challenging behaviors.  What’s even more exciting is that we were also going to teach Richie new skills – skills that had never occurred to us until we started the positive behavior support process. 

Some of the greatest lessons I learned going through this process was:

1. This is a lengthy process that doesn’t happen overnight. Try to be patient and take one step and day at a time. Try not to do everything on your own, in the plan we should have assigned tasks to all members of the team. Please note it’s okay if this can’t be helped and you are the only one doing the work (this happened to me).  Pace yourself and try not to get stressed out.
2. No steps can be missed. Please don’t think it’s okay to skip a part of the process. Each and every step of the way is equally important to solving and managing challenging behavior. The only exception is if you need to utilize your crisis plan for dealing with intense and potentially dangerous situations.
3. Collaboration is key. The school team members came up with great strategies for improving Richie’s behavior at school. But implementing the plan at home was another story. Try not to become discouraged when other team members aren’t as active (whether it’s with brainstorming ideas, collecting data, implementing the strategies, or managing the plan). You keep doing what’s right for your loved one and carry on with your plan.
4. Never underestimate your child's learning potential. This process helped me to unlock creative ways to teach Richie new skills. Now, my husband and I think of creative and new ways to teach Richie things, or expand on some of the skills he has. We went from assuming Richie wanted his own “space,” to “How can we get Richie to do or participate in this?”
5. My son and others like him have thoughts, feelings, and the desire to interact with others – despite what we may have believed or thought in the past. 

I will not cherry-coat this process.  This was a great deal of work, especially for some of the ideas that we had never implemented at home before. On the flip side, some of the easiest and smallest of changes proved to have the greatest impact for improving some of our daily routines.  

For instance, remember our plan for task demands and providing access to devices? Richie having to take a shower before bed was an issue that sparked aggressive behavior almost every single night. At about 8 pm, I would tell Richie it was time for his shower. He would motion to me to leave the room (he did this by taking my hand and pushing it away). I would then take the iPad he was listening to away from him and point to the staircase leading to the bathroom and his room upstairs. From this point on and until the end of his shower, I got pinched, hit, or pushed. Once Richie was in his bedroom, he would calm down, but then he would stay awake for most of the night pacing in his bedroom.  Thinking about the data we collected and trying to understand why this was happening, as a team, we realized:

• Richie is fourteen and 8 pm may have been too early a time for getting ready for bed (he gets up at 8:30 am to be in school by 9:30 am).
• He probably didn’t think he would get the iPad back after it was taken away for washing up. Incidentally, it wouldn't be given back to him after hitting and pinching me.
• He was just being a typical teenage boy who thinks washing up is a waste of time and interrupts the activity he prefers to do. 

We started to think about what we could do to make this routine go more smoothly. We came up with the following:

• We figured Richie could stay up until 9:30 pm, but we would make sure to make him aware of how much time he had left to play. Using a digital/visual timer was very instrumental for this.
• Using a visual schedule that let him know exactly what would happen next made things easier. The iPad would be difficult to get him to go to sleep, so we created a new routine. A dvd player that was timed to go off in two hours is a great idea that has worked.  The movie Shrek (one of his favorites) would play only on the DVD player (it’s not on his iPad) when it was time for bed.
• Having his CD player playing his favorite songs in the bathroom (again only during this time) was another idea that made things go smoother.  Richie now looks forward to his shower, and after he brushes his teeth, he asks for Shrek.

Thinking about Richie's need for attention and interaction, we started to give Richie household chores and include him in household activities.  We had never done this before because we assumed this would just annoy him and trigger bad behavior. We were surprised at how much he was willing to do and that he had very little issue with completing these tasks.

​We started with:​

​Recycling – teaching him to take the bottles and plastic items to the recycle bin outside our kitchen door. We line up cans, plastic bottles and other recyclable items on the kitchen counter. It's easy for Richie to pick the recyclable items up and transfer them to the bin. At first I thought he might be upset by us asking him to do things he never did before, but not only was he willing to do these things, he smiled while he did them!

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​Laundry – Richie could carry his hamper downstairs from his room and into the laundry room. He could load the washer. He could also move the clothes from the washer to the dryer. 

We worked on creating pictures that would help Richie to communicate better with us.  We created pictures of his favorite foods and drinks, laminated them and Velcro them to the refrigerator, freezer and pantry doors.  We were cautious about taking down the pictures of items we were out of! I also made miniature laminated pictures of food items and all of his favorite activities and put them on key chains (We have them with us at all times). Now, Richie is able to tell us exactly what he wants to drink, eat or do by either pointing to the picture or bringing us the picture. 

We also created a conversation book. This was an idea that our behavior consultant brilliantly came up with. We never thought about how Richie would be able to share things about his life with others, or that it was even possible.  The conversation book will always be a work in progress, as we know his interests and life experiences will change. 

I wasn’t sure Richie would use it, and then he surprised me one day by getting up in the middle of watching one his favorite movies to get his school yearbook and go through it.  I could easily see this action evolving into sharing his conversation book with others!

We know there will be times when Richie is going to need a break from a task or activity, or a minute longer before moving on to the next task.  We followed the strategies for teaching new skills from our Sensory and Tolerance plan, and created big communication cards that Richie can use when he wants to let us know he needs more time with an activity he's enjoying or wants to stop an activity.  I'm also working on creating a "break" card too. 

Putting the plan in place is a lengthy process. We still have some other things to create and teach Richie, and I'm sure that after he's mastered these skills, we will add new ones. I also make sure that I share anything I'm doing with all members of the team.  It's important to provide the PBS team with the same materials (pictures, illustrations, etc.) so we're all on the same page and everyone feels supported. 

​The creative ideas continue to flow, but the improvement in Richie’s behavior was paramount. We saw his aggressive behaviors decrease from seeing intense aggressive behaviors throughout the day to practically no incidents at all.  I was now able to drive with Richie in the front seat of the car, I had not been able to do this before. I was laughing and playing with my son.  I was learning about who he really is and what a fun personality he has. He likes to joke and play. Richie was happy, in a good mood and always smiling. All this time I had perceived him to be a serious person. I couldn’t have been more wrong. I was meeting my son for the first time, and it brought me to tears thinking about how much time I had wasted with so many wrong assumptions. I still have to forgive myself for that, but for now we are thrilled with the small successes, and we know we'll see more growth and improvement. There is still work for us to do. But behind that work, we now know that there's promise, hope, and Richie's future to look forward to.  

Please stay tuned for our final blog in this segment:
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Part 7: Managing the Positive Behavior Support Plan
 
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