Research-to-Practice: Reducing Behavior Problems in Students Who Are Deaf-Blind

by Deaf-Blind Perspectives on May 1, 1999
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V. Mark Durand, Project Director Christie Tanner, Project Coordinator

“If only he could talk!” Michael’s mother said as she expressed her helplessness over her son’s apparent frustration. Michael, who is deaf-blind, was screaming and biting his hand while his teacher tried to get him to participate in some schoolwork. “If only he could just tell us what he wants, what’s bothering him!” There was no blaming here, only a feeling that Michael held the secret to satisfying his own needs—if only we could get inside his head and crack the code.

Our project is designed to “get inside” Michael’s head, as well as the heads of 23 other students with deaf-blindness to determine why they exhibit problem behaviors such as aggression, self-injury, and tantrums. Once we determine why the students are displaying problem behavior, we attempt to teach them another way of telling us what they want, using vocal output communication aides (VOCAs) in an approach we call “functional communication training.” Finally, the third stage of our project is to assess whether our efforts at teaching these students specific communication strategies in school might be effective outside the school environment.

Finding Out Why Behavior Problems Occur

It is now widely agreed that treatment efforts for behavior problems should be based on the reasons why the student is misbehaving. In fact, the Individuals with Disabilities Education Act (IDEA) now requires such assessments (functional behavioral assessments) for all students with significant behavior problems. Unfortunately, despite this widespread agreement to look at why our students misbehave as the basis for any program, many professionals continue to make such assessments in informal ways, such as through conversations with teachers and parents and brief informal observations of the student. We always begin with informal observations of and interviews with significant others, but we continue the process using multiple forms of assessment, including the Motivation Assessment Scale (MAS)** and structured observations in the student’s classroom. The MAS is a questionnaire that we can give to teachers, paraprofessionals, family members, or anyone else who has a great deal of contact with the student. The MAS asks questions about where, when, and under what conditions problem behaviors occur and determines their motivations. Information from the MAS, along with other forms of functional behavioral assessments is used to design plans for reducing the behavior problems. Michael’s assessments suggested that his screaming and hand biting occurred more often when demands were placed on him. This told us that he might be acting this way because his behavior sometimes got him out of tasks in his class. His teacher might end work earlier than usual if he got upset. This taught him to get upset when he did not like the work. Clearly, this information was very important to us in designing a plan for reducing his behavior problems.

**Information about the Motivation Assessment Scale is available from the publisher; Monaco and Associates, Inc., 4125 Gage Center Drive, Suite 204, Topeka, KS 66604 (800) 798-1309, (785) 272-5501, (785)-272-5152 (fax);

Functional Behavioral Assessment Hints

Conduct two or more different functional behavioral assessments for a student’s behavior problems. This will increase your confidence that you have picked the right reasons the problems are occurring. Conduct these assessments in all settings where you expect to begin a program. Be aware that behaviors can occur in different settings for different reasons. Sometimes knowing what can make a student well-behaved (e.g., sitting next to the teacher) can tell you why the student is misbehaving (e.g., to get teacher attention). Behaviors that appear to occur for sensory reasons (e.g., repetitive behaviors) can over time be used by a student for social reasons (e.g., to avoid demands).

Using the Assessment to Design a Plan

There are many different ways to reduce behavior problems. For example, with Michael we could have simply stopped giving him any challenging class work. We knew from our assessments that making these changes in the classroom would have stopped almost all of his outbursts. But where would this have left him? Obviously, almost all educational goals would have been thwarted. Rather than remove the situations that seem to set off behavior problems, we try to teach the student how to handle these situations. Therefore, at the heart of our efforts to reduce behavior problems is the approach that teaches students other ways to tell us what they want—“functional communication training.” As we saw before, our functional behavioral assessments indicated that Michael’s screaming and hand biting were most likely efforts to escape work. Our solution was to teach him to use a vocal output communication aide (VOCA) to ask his teacher for help when the work was too difficult.

We taught Michael to communicate using his VOCA in much the same way we teach the other students in the project. Since we begin by placing the student in the situation that seems to be causing difficulties, we began by having Michael work on difficult tasks. Before he had time to get upset, we would take his hand and help him press the VOCA, which was programmed to say “Help me!” We then gave him some assistance on the task to make it easier for him. Although he could not hear the voice output, it soon became clear to him if he pressed the button on the device, the task became easier for him. After a few weeks during which time we reduced the amount of help we gave him, he began to use the device with no help each time tasks became too difficult. And, when this happened, his behavior problems were reduced significantly. Although students progress at different rates, if we pick the right situation to begin teaching based on our functional behavioral assessment we are often very successful in teaching students to ask for what they want. Their problem behaviors are in turn reduced.

Reducing Behavior Problems Hints

  • Always include strategies for teaching more appropriate skills in any plan to reduce behavior problems.
  • Do not rely simply on avoiding situations that lead to problem behavior.
  • Be sure the communicative efforts of the student are understandable to others.

Moving Out into the Community

One of the biggest challenges to designing a plan to reduce behavior problems is to create a program that will work outside special settings and with untrained persons. We need plans that will not only work with specially trained teachers and family members at school and at home, but also with the cashier at fast food restaurants, a bus driver, or the stranger on the street. To be successful in the community means that we cannot simply rely on avoiding problem situations; instead, we must teach our students how to adjust and respond to settings that are often unpredictable.

The functional communication training we just described is an ideal way to help students adapt to the community. Thus, our project extends the work in the classroom by taking the students out into their community where we identify situations that may cause them to become upset and then teach them to ask for what they might want. Because the VOCAs can be programmed to clearly communicate the students’ requests, they provide a good way to bridge the communication gap between the child who is deaf-blind and the rest of the world.

Reducing Behavior Problems with Functional Communication Training is a three-year granted project from the U.S. Department of Education, Office of Special Education Programs, Model Demonstration Projects in Deafblindness, Grant Number H025D60008. The contents of this article do not necessarily reflect the opinions of the U.S. Department of Education. _________________

This article is a reprint from Deaf-Blind Perspectives Volume 6 Issue 3, Spring 1999  

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