Applying behavior analysis to school violence and discipline problems: Schoolwide positive behavior support

The work is never ending: uncovering teamwork sustainability using realistic evaluation

Purpose The purpose of this paper is to uncover the mechanisms influencing the sustainability of behavior changes following the implementation of teamwork. Design/methodology/approach Realistic evaluation was combined with a framework (DCOM®) based on applied behavior analysis to study the sustainability of behavior changes two and a half years after the initial implementation of teamwork at an emergency department. The DCOM® framework was used to categorize the mechanisms of behavior change interventions (BCIs) into the four categories of direction, competence, opportunity, and motivation. Non-participant observation and interview data were used. Findings The teamwork behaviors were not sustained. A substantial fallback in managerial activities in combination with a complex context contributed to reduced direction, opportunity, and motivation. Reduced direction made staff members unclear about how and why they should work in teams. Deterioration of opportunity was evident from the lack of problem-solving resources resulting in accumulated barriers to teamwork. Motivation in terms of management support and feedback was reduced. Practical implications The implementation of complex organizational changes in complex healthcare contexts requires continuous adaption and managerial activities well beyond the initial implementation period. Originality/value By integrating the DCOM® framework with realistic evaluation, this study responds to the call for theoretically based research on behavioral mechanisms that can explain how BCIs interact with context and how this interaction influences sustainability.

Effectiveness evaluation of the Positive Family Support intervention: A three-tiered public health delivery model for middle schools

This article presents the results of an evaluation of Positive Family Support, an ecological family intervention and treatment approach to parent supports and family management training developed from a history of basic and translational research. This effectiveness trial, with 41 public middle schools randomly assigned to intervention or control, examined student-, teacher-, and parent-reported outcomes, as well as math and reading scores and school attendance. Multilevel analyses suggested that for students at risk for behavior problems, immediate-intervention schools outperformed control schools on parent-reported negative school contacts for students at risk for behavior problems. Implementation, however, was hampered by several challenges, including school funding cuts, lack of staff time to provide parenting supports, and staff turnover. Given that preventive interventions are generally cost effective, it is critical that researchers continue their efforts to refine these interventions and find ways to support schools' implementation of evidence-based programs that can reduce problem behavior. This article is part of a special issue "Parental Engagement in School-Based Interventions".

Changes in Heart Rate Variability Recorded in Natural Situation with T-Shirt Integrated Sensors and Level of Observed Behavioral Excitation: A Pilot Study of Patients with Intellectual Disabilities and Psychiatric Disorders

BACKGROUND

The present study investigates the possibilities of using heart rate variability (HRV) parameters as physiological markers that precede increase in observed behavioral excitation of intellectually disabled individuals. The ability to recognize or predict such patterns, especially in patients showing unpredictable reactions and language deficiencies, might be a major step forward in clinical research.

METHOD

Thirteen volunteers with intellectual disabilities, who had suffered of at least one event of overt aggression in the preceding 3 months, participated to the study. The protocol consists in the acquisition of continuous electrocardiogram (ECG) throughout approximately two times of 8 h in natural situation, using a T-shirt integrated with sensors. Simultaneously, an observer evaluates the patient's level of overt excitation from calm (level 1) to extremely tense (level 5) and send online via Bluetooth these triggers into the ECG signals. The HRV indexes were then estimated offline on the basis of the inter-beat intervals recorded by the ECG, independently for the 30 min preceding each behavioral tension marking point, averaged, and compared through non-parametric Wilcoxon matched-pairs test. Of these, the RMSSD and LF/HF calculations were used to observe the fluctuations of inhibitory activity and cardiovagal balance through different tension states.

RESULTS

Seven individuals have sufficient reliable data for analysis. They have reached at least a level 3 of behavioral excitation (moderately tense) or more (very to extremely tense, level 4 and 5) and have been retained for further analysis. In sum, a total of 197 periods of tension were kept, made up of 46 periods of slight excitation (level 2), 18 of moderate excitation (level 3), 10 of high excitation (level 4), and 5 of extreme agitation (level 5). Variations in the HRV as a function of degree of excitation are observed for RMSSD index only (inhibitory parasympathetic activity). The changes from calm to increasing levels of excitation are characterized by a significant downfall in RMSSD index when patients were evaluated to be in a very high level of tension (level 4).

CONCLUSION

The presence of precursors to agitation, reflected in the falling-off of parasympathetic activity, offers potentially interesting prospects for therapeutic development.

The Meaningful Roles Intervention: An Evolutionary Approach to Reducing Bullying and Increasing Prosocial Behavior

Bullying is a problem that affects adolescents worldwide. Efforts to prevent bullying have been moderately successful at best, or iatrogenic at worst. We offer an explanation for this limited success by employing an evolutionary-psychological perspective to analyze antibullying interventions. We argue that bullying is a goal-directed behavior that is sensitive to benefits as well as costs, and that interventions must address these benefits. This perspective led us to develop a novel antibullying intervention, Meaningful Roles, which offers bullies prosocial alternatives-meaningful roles and responsibilities implemented through a school jobs program and reinforced through peer-to-peer praise notes-that effectively meet the same status goals as bullying behavior. We describe this new intervention and how its theoretical evolutionary roots may be applicable to other intervention programs.

PBIS May Not Qualify as Classical Applied Behavior Analysis. So What?

Some disagreement exists over whether Positive Behavior Interventions and Supports (PBIS) embodies the features of Applied Behavior Analysis (ABA) as described in a classic 1968 paper by Baer, Wolf, and Risley. When it comes to disseminating interventions at a societal level, a more compelling issue is whether ABA should become more like PBIS.

School-wide PBIS: An Example of Applied Behavior Analysis Implemented at a Scale of Social Importance

School-wide Positive Behavioral Interventions and Supports (PBIS) is an example of applied behavior analysis implemented at a scale of social importance. In this paper, PBIS is defined and the contributions of behavior analysis in shaping both the content and implementation of PBIS are reviewed. Specific lessons learned from implementation of PBIS over the past 20 years are summarized.

PBIS Is (Not) Behavior Analysis: a Response to Horner and Sugai (2015)

I comment on Horner's and Sugai's article regarding the lessons learned from implementing Positive Behavioral Interventions and Support (PBIS)-that is, the things to consider when attempting to extend other works in behavior analysis to the likes of mainstream society. In adopting a critical eye toward the PBIS model, I comment first on the need for dissemination of behavioral principles to a public audience, and then outline the suggestions made by the authors for enhancing acceptance across disciplines. I clarify the definition of PBIS presented by the authors, and summarize the benefits and drawbacks associated with the conceptual argument surrounding the contention that PBIS is a behavior analytic approach to system-wide change, and argue instead for the distinction of elements in the PBIS model and their respective empirical effectiveness. I refer to other works in behavior analysis that are relevant to the current discussion and offer additional considerations for behavior analysts interested in forging ahead with endeavors that aim increase dissemination, particularly those that incorporate a culmination of alternative professional practices.

Functions of behavior change interventions when implementing multi-professional teamwork at an emergency department: a comparative case study

BACKGROUND

While there is strong support for the benefits of working in multi-professional teams in health care, the implementation of multi-professional teamwork is reported to be complex and challenging. Implementation strategies combining multiple behavior change interventions are recommended, but the understanding of how and why the behavior change interventions influence staff behavior is limited. There is a lack of studies focusing on the functions of different behavior change interventions and the mechanisms driving behavior change. In this study, applied behavior analysis is used to analyze the function and impact of different behavior change interventions when implementing multi-professional teamwork.

METHODS

A comparative case study design was applied. Two sections of an emergency department implemented multi-professional teamwork involving changes in work processes, aimed at increasing inter-professional collaboration. Behavior change interventions and staff behavior change were studied using observations, interviews and document analysis. Using a hybrid thematic analysis, the behavior change interventions were categorized according to the DCOM® model. The functions of the behavior change interventions were then analyzed using applied behavior analysis.

RESULTS

The two sections used different behavior change interventions, resulting in a large difference in the degree of staff behavior change. The successful section enabled staff performance of teamwork behaviors with a strategy based on ongoing problem-solving and frequent clarification of directions. Managerial feedback initially played an important role in motivating teamwork behaviors. Gradually, as staff started to experience positive outcomes of the intervention, motivation for teamwork behaviors was replaced by positive task-generated feedback.

CONCLUSIONS

The functional perspective of applied behavior analysis offers insight into the behavioral mechanisms that describe how and why behavior change interventions influence staff behavior. The analysis demonstrates how enabling behavior change interventions, managerial feedback and task-related feedback interact in their influence on behavior and have complementary functions during different stages of implementation.

Sexual behavior and intention to engage in sexual behavior in junior secondary school students in Hong Kong

STUDY OBJECTIVES

The present study examined the prevalence, changes, and demographic as well as psychosocial correlates of sexual behavior and intention to engage in sexual behavior in early adolescents in Hong Kong, with sexual behavior indexed by sexual intercourse.

DESIGN

Three waves of longitudinal data on sexual intercourse, intention to engage in sexual intercourse, family functioning, and positive youth development were collected from 28 secondary schools in Hong Kong.

RESULTS

There were significant influences of grade and gender on adolescent sexual behavior or intention to engage in sexual behavior. Significant main effects of immigration status on sexual behavior were also found. While no effect of family economic background was found, effect of family intactness existed for sexual behavior. Family functioning and positive youth development at Grade 7 were negatively associated with students' sexual behavior and intention to engage in sexual behavior at Grade 9.

CONCLUSION

Grade, gender, immigration status, and family intactness were related to sexual behavior and/or intention to engage in sexual behavior in junior secondary school students. Promoting positive youth development and family functioning could serve as protective factors to reduce sexual behavior and intention to engage in sexual behavior in Chinese early adolescents in Hong Kong.

Positive behavior support and applied behavior analysis

This article reviews the origins and characteristics of the positive behavior support (PBS) movement and examines those features in the context of the field of applied behavior analysis (ABA). We raise a number of concerns about PBS as an approach to delivery of behavioral services and its impact on how ABA is viewed by those in human services. We also consider the features of PBS that have facilitated its broad dissemination and how ABA might benefit from emulating certain practices of the PBS movement.

Classroom misbehavior in the eyes of students: a qualitative study

Using individual interviews, this study investigated perceptions of classroom misbehaviors among secondary school students in Hong Kong (N = 18). Nineteen categories of classroom misbehaviors were identified, with talking out of turn, disrespecting teacher, and doing something in private being most frequently mentioned. Findings revealed that students tended to perceive misbehaviors as those actions inappropriate in the classroom settings and even disrupting teachers' teaching and other students' learning. Among various misbehaviors, talking out of turn and disrespecting teacher were seen as the most disruptive and unacceptable. These misbehaviors were unacceptable because they disturbed teaching and learning, and violated the values of respect, conformity, and obedience in the teacher-student relationship within the classroom. The frequency and intensity of misbehaviors would escalate if students found it fun, no punishment for such misbehaviors, or teachers were not authoritative enough in controlling the situations. Implications for further research and classroom management are discussed.

Positive Behavior Support and Applied Behavior Analysis

Positive behavior support (PBS) emerged in the mid-1980s as an approach for understanding and addressing problem behaviors. PBS was derived primarily from applied behavior analysis (ABA). Over time, however, PBS research and practice has incorporated evaluative methods, assessment and intervention procedures, and conceptual perspectives associated with a number of additional disciplines. Recently, there has been some confusion regarding the definition of PBS and, in particular, its relationship to ABA. In this article, it was noted that the practice of PBS and ABA, in some instances, can be indistinguishable but that important differences in definitions and emphases mandate an explicit distinction. The purpose of this article is to address some of the key points of confusion, identify areas of overlap and distinction, and facilitate a constructive and collegial dialog between proponents of the PBS and ABA perspectives.