Working with individuals with developmental disabilities who are disruptive can
be challenging and frustrating.  The first thing to consider is that trying to solve
an emotional issue with logical argument rarely will result in a positive outcome.  
The caregiver should determine what is this behavior communicating:
A.  Is it an attention seeking behavior?
B.  Is it an environmental issue?
C.  Is it a learned behavior in which the individual, by controlling the situation     
has been rewarded positively in the past?
D.  Does it fulfill some emotional need?
It is not impossible to write a meaningful objective for such behaviors in which a
daily data collection can be analyzed.  Similarly, a formal behavior modification
plan written by a professional can be incorporated into a regular data collection
sheet so that dealing with these behaviors are not separate from other activities
of daily living.
 Most ADL (Activities of Daily Living) objectives are written for
the purpose of progression in current skills such as dressing, showering, toileting
and reading.  An ADL objective for showering may be, "I will pour the correct
amount of shampoo in my hand while showering."
 Behavioral objectives on the
other hand are written for the purpose of eliminating or reducing undesirable behaviors
and increasing the desirable behaviors.  Thus behavioral objectives can not be written in
the same fashion as the ADL skills objective.
For example, a behavior objective:  Joe will not disrupt the caregiver during her
documentation time by not entering her office.
The objective describes the positive outcome but it does not provide the steps
required to achieve it.  Instead, for example in the case of attention seeking
behavior, an objective should focus on the behavior not the act:
Joe will have a 3 minutes one-on-one time with his caregiver when he
independently refrain from interrupting her during documentation time.
Methods: Caregiver will praise Joe for not interrupting her and engages in a three
minutes activity of Joe's choice.
Assuming that one on one attention is important to Joe, the objective has both
the processes and achievable desired outcome.   
However, in its current format, the objective can result in increased attention
seeking behaviors and may even introduce additional undesirable behaviors if the
individual interpret the process as a bribe.  The scenario goes something like this:
Caregiver tells Joe, "if you don't interrupt me when I am doing my paperwork, I
will play a card game with you or whatever you like".  He does not interrupt her
and gets his reward.  Then Joe having learned that the act of disruption has
gained him reward, begins to disrupt other situations in hopes of additional
rewards and thus the behavior increases.  An effective objective may look like
this:
When Joe independently refrain from interrupting his care giver during
documentation time, he will be rewarded with 3 minutes activity of his choice.
Methods: Caregiver will:  Look for opportunities when Joe independently refrain
from disrupting during documentation time and praise him for his decision and
offer him a 3 minutes one on one activity of his choice.
The objective has both the processes and achievable desired outcome and it is
more likely to decrease the behavior.  The scenario goes something like this:
The care giver finds an opportunity in which she is not disrupted by Joe during
documentation time.  She approaches Joe and says, "Joe, I am proud of you for
your good behavior today.  Lets go do something together; I have about 3
minutes.  What would you like to do?"
In this scenario, Joe's independent decision of not disrupting (the behavior) was
rewarded not his action.  Further, the concept provides Joe with skills to control
his own impulses.  Also, note that in this scenario the caregiver can provide
intermittent positive reinforcements which can easily be phased out when
caregiver choose to do so.  In the first scenario, the frequency of the
reinforcements are determined and more likely demanded by Joe.
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