Positive Behavior Supports

Mike Mayer: The concept of positive behavioral supports basically means that what we've done is that we've really spent some time to understand the person. Rather than just looking at the behavior and saying, "Oh, he's hitting himself, we have to stop the hitting, we will grab his hand hold his hand down. Or he likes chocolate, so every time he hits himself, we're going to take one of his chocolates squares away". Or whatever the behavior management or behavior modification mindset was.

We start with really trying to pay attention to what is underlying the reason for the behavior. What are they trying to accomplish? What are they trying to communicate with their behavior? Do what's called a functional behavior analysis and we say, Okay, well what does it seem like he gets out of this? Or what is it that she's trying to accomplish that she can't seem to somehow reach?

We take a look… more and more we're spending time looking at the fundamental motivations for the behaviors. What are the stressors, the psychosocial, environmental stressors that they're experiencing that may be contributing to those kinds of things that are causing them to stress? And if we can remove some of those distresses from their world, would that make it less likely that they're going to engage in them?

It used to be that we would say that it was the antecedents, the behavior and then the consequences. That's the old school hard-core behavior management approach. You looked at the behavior and then looked at what came right before it. And then you said, "Okay, well, when they're in the kitchen, they do this." Now we didn't try and figure out necessarily why they were doing that when they were in the kitchen, but we knew that it was when they were in the kitchen, they would grab the knife, and so we needed to create consequences to try and make that behavior stop of grabbing the knife

Well in, in our old school approach, it was simply move the knife away or keep him out of the kitchen, or when he goes into the kitchen, you stand within 2 inches of him and, if he reaches for the knife, you say, "No, bad. Don't grab the knife," and then you give him some kind of consequence for his behavior.

And the problem with that approach is, is it one, it never teaches him how to appropriately handle a knife. It doesn't teach him to engage within a kitchen. It doesn't help us figure out why he wanted to have the knife in the first place. It doesn't provide an appropriate or acceptable outlet for him being able to do whatever it was he was trying to do, and we're always playing catch-up with the consequences, because we design a consequence based on yesterday's behavior, but by the time he does it again and we can implement yesterday's consequence, that behavior's now twice as strong, even if he only did it one more time.

So we reach a point where the consequences become aversive or punitive to the point where we could no longer ethically and legitimately say, "Yeah, we're going to do that. This, this is okay for us to do." Because people started objectively looking at it and saying, "Well, wait a minute. Does this make sense even that we're, we're punishing him for wanting to be in the kitchen in his own home?" And we've had to… we stopped and we said, "Wait a minute. Let's spend more time looking at the antecedents, and let's spend less time worrying about the consequences of what we're going to do to someone. Figure how to make it more natural and more logical."

So if he's wanting to be in the kitchen and he wants to have a knife, can we figure out why he wants to do that? Maybe, you know, he used to cut vegetables with his mom to make chicken noodle soup and that's the only thing he remembers about his mom was standing there and cooking and making chicken noodle soup. Well, let's see if we can find a knife that he can handle, that he can manage, that isn't going to cut his hand, and, and see if he can really chop celery or not. Maybe he's really good at it.

So the difference to me largely is that instead of just looking at the, the behavior and then deciding what consequences we're going to create to affect that behavior, we look at the person and say, "What can we do on the front end to make it a happier, healthier life without having to create all kinds of artificial consequences to change that behavior."