12 KEYS TO SUCCESSFUL BEHAVIOR IMPROVEMENT: "The Dirty Dozen"

1. EMPATHY: in order to assist another person to overcome behavioral challenges, one must first do everything possible to understand that person's life experience and how s/he perceives everyday situations. Taking the time to examine the life experiences of the individual and to maintain a focus on these and how they may affect the individual and how s/he behaves in various situations creates behavior improvement efforts in which the individual and those assisting collaborate rather than one controlling another. One seeks to help the individual solve problems s/he faces, rather than merely helping to solve the problems s/he presents to others. One seeks to understand what is bothering the individual that causes her or him to behave in certain ways, rather than to merely understand how s/he is bothering others. This results in more sensible and more permanent change.

2. OPPORTUNITIES (Antecedents): materials, equipment, locations, rules, instructions, expectations, guidelines, schedules, physical senses, etc., make it possible for someone to engage in an activity. In order to assist another to overcome behavioral challenges, one must identify Opportunities that exist for performance of behavior considered problematic and reduce these factors that correlate highly with the occurrence of problem behavior. Opportunities that do or could exist for performance of more constructive behavior are to be maintained and increased. Manipulation of Opportunities provides the simplest means of assisting someone to improve when that individual already possesses the necessary Skills and motivation.

3. SKILLS (Behavior): many behaviors considered problematic involve quite skillful performance; more constructive behaviors to replace these also typically involve skillful but different performance. In order to assist another to overcome behavioral challenges, one must arrange for unlearning, forgetting, or at least refraining from practicing the Skills involved in behaviors considered problematic. Promote development of more constructive Skills using Direct Instruction [see below].
Direct Instruction of new Skills provides the simplest and most direct means of helping another improve in situations where the necessary Opportunities and motivation already exist.

4. INCENTIVES (Consequences): people behave in the ways they do because particular behaviors bring predictable desired ends. In order to assist another to overcome behavioral challenges, one must identify the desired ends achieved by engaging in behaviors considered problematic and discontinue these while increasing the desired ends achieved by engaging in more constructive behaviors, especially those that make up the focus of one's skill development efforts, and arrange for and increase these.

Most people strive for the desired ends of interaction (attention), relief from something unpleasant (escape, avoidance), accrual of material items (tangible gain), and/or excitement (sensory stimulation). (I.R.M.E. = Interaction Relief Material Excitement) Fortunately, the first two of these, primarily responsible for most behaviors in which people engage, one can usually readily control. Even if it does not serve as a primary desired end for engaging in a particular behavior considered problematic, paying attention to more constructive things another does – increasing interaction when certain things occur - will reliably cause these things to occur more often. Arranging Incentives provides the most immediate and direct means of affecting improvement even while analyzing Opportunities and Skills.

5. DESCRIPTIVE ACKNOWLEDGMENT (praise): a way to pay attention to more constructive, desirable, and acceptable behaviors that could render performance of behaviors considered problematic unnecessary. In order to assist another to overcome behavioral challenges, one must choose a number of targeted more acceptable behaviors and provide Descriptive Acknowledgement to their occurrence on a very frequent and consistent basis, a way of manipulating Incentives. The focus may be on merely refraining from problematic behavior, engaging in incompatible alternative behaviors, and/or engaging in other forms of replacement behaviors. Typically, all three of these are combined. Descriptive Acknowledgement, a form of straightforward positive feedback with social and physical components, includes both an indication of the value of a particular behavior when it occurs and detailed information about the criteria of successful performance. By focusing on what the person does right, Descriptive Acknowledgement also contributes to enhanced self esteem on the part of the person receiving assistance and builds some level of trust. (Please see supportive document “Descriptive Acknowledgment” for further detail.)

6. DIRECT INSTRUCTION: a method for developing new Skills in individuals who have demonstrated difficulties in learning. Individuals considered disabled, especially those facing significant behavioral challenges, most often do not learn very well through observation, trial and error, or general experience. In order to assist another to develop a specific skill, one must explicitly set about teaching it. This "Direct Instruction" involves the use of a "task analysis", in which one breaks down the entire skill into a number of smaller steps. For example, the "skill" of turning on an overhead room light might involve the steps of entering the room, locating the switch, approaching the switch, reaching for the switch, and moving the switch upward. The number of steps making up any particular skill depends on how easily the person learning the skill achieves success, rather than on the skill itself. Repeated successful practice of performing the steps of the skill in exactly the same fashion leads to the most rapid learning. The learner may practice all of the steps each time, or only a few -- the first or last several steps -- gradually expanding until practicing the entire skill. This depends upon how difficult learning the skill appears for the individual.

7. GUIDED PRACTICE (manual guidance; graduated guidance): a way to provide Direct Instruction of new Skills or to repair Skills partly or incorrectly learned. In order to assist another to overcome behavioral challenges, one must provide enough Guided Practice in performing each selected skill to enable the person to achieve successful independent performance or at least to determine what level of permanent support s/he will require to maintain performance in the future. Guided Practice ranges from 100% hand over hand physical assistance with which the person cooperates fully to simple modeling or gesturing which the person copies. By promoting smooth, successful practice and preventing error performance, Guided Practice assists in developing competencies on the part of the person receiving assistance, further contributing to that individual's self esteem. Guided Practice also includes environmental arrangements that promote successful performance. (Please see supportive document “Guided Practice/Restoration” for further detail.)

8. NONREACTIVE MONITORING (ignoring): a way to "deactivate" behaviors considered problematic and previously effective for the person in achieving desired ends. In order to assist another to overcome behavioral challenges, one must practice Nonreactive Monitoring during the occurrence of all behaviors considered problematic until the person ceases to perform them to achieve any desired end. This can only occur with certainty in the context of Descriptive Acknowledgement, Guided Practice, and the other factors mentioned above. Nonreactive Monitoring includes exhibiting no reaction to the occurrence of behaviors considered problematic while remaining vigilant for a return to more acceptable behavior and returning to providing Descriptive Acknowledgement at that time. Nonreactive Monitoring also includes arranging for other Incentives besides Interaction (Relief, Material, Excitement) to not occur as a result of the problematic behavior. This may require extensive planning and preparation to reduce untoward consequences. By providing this nonreactive context combined with reestablishing interaction and other incentives as soon as more acceptable behavior returns, Nonreactive Monitoring not only "deactivates" behaviors considered problematic but establishes a level of trust and assurance that you will not abandon the person regardless of how badly s/he may behave. (Please see supportive document “Nonreactive Monitoring” for further detail.)

9. SHAPING: gradual and systematic building up of the components of new Skills or activity sequences, which take shape just as a piece of art takes shape little by little under the efforts of an artist. Assisting another to overcome behavioral challenges most often involves the development of new Skills. By gradually accomplishing more and more skillful performance increasingly similar to the eventual goal, Shaping allows the greatest overall continuing success. The use of Shaping enables teaching of virtually any new skill to another, and goes together extremely well with Direct Instruction and Guided Practice. The steps involved in Shaping may at first appear to have little to do with the eventual skill performance. For example, teaching someone to watch a television program for 30 continuous minutes -- a valuable solitary leisure skill -- often begins with asking only that the person remain very briefly (e.g., one minute) in the room containing the television, without necessarily looking at it, sitting down, choosing a channel, adjusting the volume, or others of the many parts of watching a television program. Shaping is similar to a sculptor gradually creating a recognizable figure from a solid block of stone.

10. FADING: gradual and systematic reduction of external supports of successful performance, while maintaining success. The level and amount of assistance an individual requires at first to succeed with a new skill or activity does not matter at all. The initial goal focuses on successful performance regardless of required support. Over time, reduction of supports can lead to more independent performance. Some individuals performing some Skills or activities will require some amount or kind of permanent support, or at least reach a point where additional Fading of support must occur exceedingly gradually, sometimes over the course of many years. Fading allows determination of what level and what kind of support an individual will require to remain successful.

11. OK/NOT OK RECORD (data): documenting change by recording occurrence or nonoccurrence of specific targeted behaviors. Records may include as little or as much detail as one chooses and/or has resources to gather. Most important, OK/not OK provides a "doable" form of record keeping that accurately and sensitively reflects change so one can monitor the effects of behavior improvement efforts. Technically partial interval time sample recording, the OK/not OK Record consists of a grid of daily time blocks – for example, 30 minute periods - each of which is scored for whether targeted behaviors occurs. (Please see supportive document “OK/not OK” for further detail.)

12. COMMUNICATION: strategies, materials, Skills, equipment, etc., permitting Communication permeate every aspect of successful behavior improvement. This generally means transfer of information both to and from the individual. In order to assist another to overcome behavioral challenges, one must make accessible to that individual the maximum amount of information about the events, activities, conditions, etc., of that individual's life. Photographs, word cards, schedules, calendars, preparatory explanations, etc., can all assist in this, allowing the person to anticipate and prepare for future events. Events then less often "surprise" the person, typically leading to some immediate behavioral improvement. Photographs, word cards, speech and language instruction, adaptive equipment, etc., all can assist in permitting general kinds of conversation about personal private and public concerns, making reminiscence possible, and making choices, as well as the more typical limited focus on making it possible for the individual to make requests, an important but truly small part of everyday life.