As you have learned in previous units, all behavior (prosocial behavior as well as challenging behavior) serves a function. Once a patient’s challenging behavior has been identified, defined, and prioritized, the BCBA will determine the outcome goals and conduct a functional assessment.
After the assessment, the BCBA will create a behavior intervention plan, or BIP, to address that behavior using function-based interventions that address the function of the challenging behavior.
A behavior intervention plan (BIP) is defined as a detailed written description of a problem behavior and the interventions designed to reduce the behavior.
The goals of a BIP are twofold:
We have many different interventions that we can use for each behavioral function. Some of these interventions are implemented before the behavior occurs to keep it from happening, some teach a more appropriate, alternative behavior, and some are implemented after a behavior has already occurred.
Consistency is key! Behaviors will only change if interventions are implemented consistently across
Behavior intervention plans (BIPs) include several components, all designed to decrease inappropriate or challenging behavior and increase appropriate replacement behaviors. These sections include
Operational definition is a clear, concise, accurate statement that specifies the exact details of an observable behavior. This includes both the topography and function(s) of the behavior. The operational definition specifies
EXAMPLE
A patient may engage in 10 tantrums per day before the intervention, but after the BIP is in place for a few months, they might only engage in three tantrums per day.The term goal describes what the expected decrease is and when it should occur. The BCBA describes the amount of behavior change required in order for it to be considered meaningful for the patient. Is it sufficient if the behavior occurs less frequently than before the intervention or must the behavior be occurring below a certain rate per hour or day for it to be considered a meaningful change?
Measurement refers to observing the behavior and recording its occurrence. The BIP tells us what types of measurement to use to track each behavior. There are several ways to measure behaviors, such as:
Antecedent interventions, or antecedent-based interventions, are designed to prevent the problem behavior from occurring by changing the environment and interactions with the patient BEFORE an inappropriate behavior occurs. They make the challenging behavior less likely to occur.
EXAMPLE
If Simien hits to gain access to preferred toys at bath time, then prompting him to appropriately ask for the bath toys before he hits will result in Simien having no need to hit to get access to what he wants.At clinic, so we're going to suggest to make a visual schedule because he's been having a hard time walking outside. So look, what's this first? There's dad. There's you. There's Miss Shareen.
You're holding hands like you're walking on the sidewalk, holding, holding.
Hands.
Hands-- and then when you get to the grass you stop.
Stop.
You stop.
You stop.
Yeah. You stop, and then what do you get to do? You get to run on the--
Grass.
Say, "Run on the grass."
Run on the grass.
Good job. The end.
Yeah, so we were able to show him along the way as every step-- you walk out, you hold hands, and emphasize holding hands. You guys walk in the sidewalk holding hands. And then the next picture is you guys stopping in front of the grass, still holding hands. And then his reward is--
You get to play.
You get to play on the grass. And he got the concept or really, the idea. Every tantrum he has, really a lot of his bad behaviors, because he doesn't know.
Yep. What do we got to do first?
Remember, what are you going to do first, Paul? Do you want to do it, or you want me to do it?
Paul?
Once he sees your picture, he'll--
Hands-- go hold hands with dad like the picture.
Good, good.
All right.
There are many different types of antecedent interventions, which we will be looking closer at in a future section.
Replacement behavior refers to appropriate alternative behaviors that will be taught to the patient and can be used as substitutes for the problem behavior. Replacement behavior is what you teach your patient to do instead. These substitutes require prompting and teaching. We will be looking closer at them in a future section.
Where do you guys [INAUDIBLE]?
Right here and then we made him ask.
Yeah, and then we stop and make him ask.
Look! Look!
[INAUDIBLE] can you say, I want to play on the grass?
Want play grass.
OK, go.
Yay!
Go, go, go.
Have you hugged your tree today?
He seems so--
You going to kiss it too?
He's a tree hugger and a tree kisser.
Lastly, consequence interventions involve what to do if the problem behavior occurs. Consequence interventions specify how you should react when the problem behavior occurs. The goal is to make it less likely to happen again in the future. We do this by
Do you want stairs or grass?
Grass.
OK, stay with mom. 10 steps, 10 steps. Ready? 1, 2, 3-- stay with me.
10 steps.
1, 2, 3, 4, 5, 6, 7, 8, 9--
10.
10. Do you want grass?
I want grass.
OK, go.
Before the BIP gives the patient interventions (antecedent interventions, replacement behavior, consequence interventions), they detail general information about the behavior. This can include the target behavior, operational definition, function, baseline, and goal.
Here is an example of what this might look like:
