Example of Severe Behavior Treatment Plan
Programs to address more severe challenging behavior are less likely to be packaged as part of a manualized approach to intervention. Instead, these programs are individualized and tailored to the specific function(s) of challenging behavior exhibited by the person and the specific safety concerns those behaviors may pose. We have provided an example of a treatment plan used to address severe challenging behavior here. A brief excerpt from the plan is included below:
Background and Outcomes
Desmond (pseudonym) is an 8-year-old male diagnosed with Disruptive Behavior Disorder and Autism Spectrum Disorder. He was admitted to the Center’s Challenging Behavior Program on **/**/**** for the assessment and treatment of Aggression, Disruption, Self-Injury, and Negative Vocalizations. Desmond has a history of engaging in these challenging behaviors. A functional analysis was completed during the admission with results indicating that he will engage in Aggression, Disruption, Self-Injury, and Negative Vocalizations to access adult attention and tangible items.
Caregiver Goals
Each caregiver goal is listed below in addition to whether or not this goal was met during the admission.
- Desmond will comply with a demand without becoming aggressive or having mom scream or have to threaten to take away an item at least 80% of the time. Goal Met: Yes
- Desmond will not bother mom when she tells him she is not available at least 80% of the time. Goal Met: Yes
- Desmond will give up his tablet for at least 30 minutes with at least an 80% reduction in challenging behavior and will engage in an alternative activity when his tablet is removed. Goal Met: Yes
Process Goals
- Functional Behavioral Assessments (FBA) were conducted to identify the potential variables that contribute to the Desmond’s challenging behavior. When possible, a Functional Analysis (FA) was conducted; however, when an FA was not feasible other FBA methods were used to identify function. Goal Met: Yes
- Based on the results of the FBA, a treatment package was developed. Goal Met: Yes
- The treatment package was generalized throughout the Center and to the home or community. Goal Met: Yes
- Caregivers were trained to implement the treatment package. Goal Met: Yes
Example Treatment Recommendation: Extinction
Do not provide access to preferred items, attention, or escape from work when Desmond is engaging in challenging behavior, to calm him down.
- Preferred items: do not provide access to his tablet or his toys
- Attention: do not make comments (e.g., “stop it, I don’t like that”), provide physical attention (e.g., hugs, back rubs), roll your eyes, or discuss challenging behavior with others in front of him (e.g., “Did you see that?”)
- Escape from work: do not provide a break from demands and use Three-Step (see full example for info)
